MST-Department of Foods, Nutrition & Dietetics
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Item Maternal Knowledge, Attitude and their Utilization of Nutrition Information in the Mother and Child Health Handbook in Bungoma County, Kenya(Kenyatta University, 2024) Walukana, JulietThe use of the Mother and Child Health handbook in most countries that have adopted it has shown provision of a good continuum of care to children. The information captured in the handbook about the mother during pregnancy until delivery is crucial to help health care workers as they offer health services to the mother. In Kenya, the proportion of children below 6 months who are exclusively breastfed is 60% while only 43.3% in Bungoma County are exclusively breastfed. Only 21 % of children in Kenya aged 6-23 months receive an appropriate diet in line with the recommended infant and young child feeding guidelines. In Bungoma County, only 22% of children in that age group are fed appropriately. The prevalence of stunting in Bungoma County stands at 19%, wasting 2.3% and underweight 9.6%. Poor breastfeeding practices and inappropriate complementary feeding are some of the main contributors to these poor indicators. Strengthening the use of the Maternal and Child Health handbook can help in curbing some of these preventable problems. Minimal information exists on maternal and caregivers’ knowledge, attitude and utilization of nutrition information in mother and child health handbook. In Bungoma County, 98.6% of pregnant women attended Ante Natal Clinic (ANC), 69% took the iron supplements and only 7% took folic acid and iron supplements for 90 days or more as recommended by the Ministry of Health. On skilled deliveries, only 79.3% of the women delivered in a health facility. About 49% of the mothers attended post-natal clinic within 48 hours while only 31% of newborns received neonatal checkups. The aim of this study was to assess the maternal and caregivers’ knowledge, attitude and utilization of nutrition information in mother and child health handbook in Kanduyi Sub-county of Bungoma County. Systematic random sampling was used to select the targeted sample form each health facility. A semi-structured questionnaire was administered to 216 mothers who were randomly selected with children below 5 years. Focus Group Discussion guides and Key Informant Interviews were used to gather more information. For data analysis, version 22 of SPSS was used. Socio-economic and demographic characteristics, knowledge, and attitude were described using descriptive statistics. Relationships and associations among dependent and independent variables were determined by use of chi-square test logistic regression. Qualitative data from Focus Group Discussions and Key Informant Interviews were translated, coded and arranged in an orderly manner to determine the evolving concepts. The mean age of respondents was 28 years. Majority had attained secondary education at 36.9% while casual labour was the main source of income at 21.8%. Findings showed that 83.5% of the caregivers had high knowledge on duration of breastfeeding and 38.0% had low knowledge on weight and height taking. Statistically significant associations were noted between knowledge of breastfeeding and utilization p=0.004 (COR, 0.42, 95% CI 0.23-0.75, as well as attitude on sufficiency of breast milk and utilization p=0.004 COR,1.68, 95% CI,1.18-2.41. Health education should be enhanced at antenatal and child welfare clinics so that mothers get knowledge on all aspects of nutrition.Item Eating Habits, Overweight and Obesity among Nutrition Students from Molo, Karen, and Nyandarua Kenya Medical Training Colleges, Kenya(Kenyatta University, 2024-10) Mwaniki, Bridget NdutaGlobally, obesity and overweight have been on the rise among college students. In 2022, two and a half billion adults aged 18 years and above (43%) were overweight, and of these, 890 million people were obese (16%). Moreover, a prevalence of 16.5% of overweight was reported among Kenyatta University students in Nairobi, Kenya in 2024. Many factors make college students nutritionally vulnerable. 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. Therefore, this study’s purpose was to establish the environmental and individual factors, eating habits and nutrition status among nutrition students of Kenya Medical Training College (KMTC). The study adopted a mixed methods cross-sectional analytical study design that collected both quantitative and qualitative data. Two hundred and ninety three (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. Descriptive statistics; dispersion, means, frequencies, and Chi- square 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. 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 meals of the students comprised mainly of ugali, kales, rice beans/green grams, chapati beans/ green grams, and rice, carrot, peas, ugali and cabbage. The diets of majority of the respondents (87%) were diverse, where they consumed a daily minimum recommended meal frequency of five meals. Sub-optimal eating habits were reported including consuming unhealthy snacks, skipping meals, and poor dietary diversity. About a fifth (20.5%) of the respondents were overweight and 7.5% were obese. Slightly less than one third (26.3%) and slightly less than a half (46.1%) of the respondents engaged in vigorous and moderate physical activity respectively. 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’ BMI (p=0.034) and 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). Higher nutrition knowledge was associated with the practice of recommended eating habits (AOR = 0.265, p = 0.006). There was no association between nutrition knowledge and nutrition status of the study participants. There is therefore need sensitize KMTC students on healthy eating habits. KMTC management should also ensure that the college physical environment supports healthy eating habits.Item Nutritional Status, Dietary and Physical Activity Practices, Adults with Type II Diabetes Attending Nakuru Level Five Hospital, Kenya(Kenyatta University, 2024-11) Opiyo, Beatrice AtienoType II Diabetes Mellitus (TIIDM), formerly known as non-insulin-dependent diabetes mellitus (NIDDM), is a chronic metabolic disorder characterized by hyperglycemia. Nutrition and physical activity improve glycemic control, moderate to vigorous physical activity (30 min/day for five days/week) is recommended for the management of type II diabetes mellitus-related complications. Despite studies showing that nutritional status, dietary intake and physical activity practices are significant in managing Type II diabetic adults, data on the same is scanty in Nakuru County Referral and Teaching Hospital. The study's main objective was to assess the nutritional status, dietary practices and physical activity level of Type II diabetes adults attending NCRTH. The study utilized a cross-sectional analytical design among 105 adults recruited by systematic and simple random sampling from a sample of about 400 adults, 99 of whom consented. The respondents were diabetic adults aged 20–70 years and had the condition for more than one year. Nakuru County Referral and Teaching Hospital NCRTH was purposefully selected, considering its well-established diabetic clinic. A researcher-administered questionnaire was used to collect data on the demographic and socio-economic characteristics of the respondents, dietary practices, nutritional status, and fasting blood glucose. The Global Physical Activity Questionnaire collected data on physical activity. The Statistical Package for Social Sciences (SPSS) Version 20.0 was used to manage data. The results showed the respondents' mean age was 54.77 ± 8.82 years. The majority of the respondents 63.6% were female, 48.5% were 50-60 years old, 62.6% married, 33.3% had formal employment, and 50.5% had a monthly income ranging from 20,000-50,000. Mean energy intake per day was 2376.4 ± 156.2 and 2265.7 ± 134.2 kcal for male and female respectively. The respondents recorded overweight and obesity of (59%) and central obesity of 68.7%, and majority (62.6%) were engaged moderate physical activity. The results from Pearson correlation coefficients showed that blood glucose levels had a strong positive correlation coefficient with energy intake (r = 0.72, P < 0.0001), number of meals (r = 0.55, P < 0.0001), dietary diversity score (r = 0.52, P < 0.0001), physical activity (r = 0.64, P < 0.0001), and nutrition status (BMI) (r = 0.57, P < 0.0001). However, there were no significant associations with socio-economic parameters such as age, gender, education level, or marital status. Respondents with energy intake within recommended levels were 1.4 times more likely to have average normal blood glucose than those with excess (OR = 1.42, P<0.0001). The study concluded that dietary practices characterized by high intake of calories and low physical activity are associated with a greater risk of diabetes complications within TIIDM adults. The study recommended that NCRTH diabetes clinic implement wellness program on dietary intake and physical activities per diabetes adult and regular consultation with nutrition programs to manage blood glucose level of adults with TIIDM and associated complications.Item Feeding Practices, Challenges and Nutrition Status of Infants with Orofacial Clefts Attending African Inland Church Kijabe and Cure Hospitals, Kiambu County, Kenya(Kenyatta University, 2024-08) Maina, Annastacia WaitheraOrofacial clefts are among the most common congenital disorders across the globe. Recent research indicates that in every three minutes a baby is born with a cleft. Inadequate nutrition in the critical months can lead to impaired nutritional status and growth failure in the cleft population resulting in delayed surgery which can have an impact on overall health and development. At the time of the study, the infant and young child nutrition guidelines in our country were lacking detailed information addressing the feeding challenges in the cleft population. This study therefore sort to ascertain the feeding practices, associated feeding challenges and the nutrition status of infants with orofacial clefts attending AIC Cure and Kijabe Hospitals. The main objective was to determine the feeding practices, associated feeding challenges, nutrition status and to establish the relationship between the variables. A cross-sectional analytical design was adopted on a sample size of 107 infants together with their caregivers. A researcher administered questionnaire was used to collect data. Data was analyzed using SPSS version 25. Logistic regression was used to show the direction and the magnitude of the associations between the factors associated with infant’s nutrition status at 95% confidence interval. A p value of < 0.05 was considered as statistically significant. Nutrition status was analyzed using Ena software for Smart. Descriptive statistics such as means, standard deviations, frequencies and percentages were used to describe the study population. The Chi-square test was used to establish the association between the independent variables and the outcome variable (nutrition status). Results showed unemployed caregivers were 40.2% with 49.5% having an average household income of less than KSh 10000. Infants less than 6 months were the majority at 54.2%. Early initiation of breastfeeding within 1 hour was at 29.0 % those who were exclusive breastfed at 28.0%. Infants who were bottle fed were at 47.6%. The minimum acceptable diet was 16.3%. Global malnutrition was at 17.8% (95% CI: 11.7-26.1). Global underweight at 31.8% (95% CI: 23.7-41.4) while global stunting was at 33.6% (95% CI: 25.4-43.0). Morbidity status for this study was at 35.5%. The study established a significant association between the caregivers’ occupation and infant nutrition status (P value = 0.09 df = 1, OR= 13.231). In addition, there was a significant association established between the caregivers’ average household income and children nutrition status (P value = 0.047 df= 2, χ2 = 5.717). Caregiver’s occupation (AOR= 12.1; 95% CI, 1.60-25.81; p value = 0.019), child’s age (AOR = 2.6; 95% C.I, 0.93-7.00, p value 0.05), caregivers average household income (AOR= 5.0; 95% CI, 1.13-21.80, p value = 0.034) and meal frequency (AOR = 5.0, C.I, 1.032-24.064, p value = 0.046) were the predictors of the children nutrition status. Equipping health care providers adequately in knowledge to early identify and address the feeding difficulties that infants born with orofacial clefts present with and prioritizing prevention of malnutrition in all its forms by consistent follow up and intervening appropriately at each encounter were some of the recommendations made.Item Relationship between Intake of Energy-Dense Diets and Nutritional Status of Adolescents in Primary Schools in Nairobi City County, Kenya(Kenyatta University, 2024-06) Muinga, Evelyne NdungeEnergy-dense diets are of low nutrient quality but high energy content and this may have adverse health outcomes. There is limited information regarding the relationship between the intake of energy-dense foods and adolescents' nutritional status. The study aimed to establish how the intake of energy-dense diets relates to the nutritional status of adolescents in Nairobi County. The study was a mixed-method research design combining qualitative and quantitative techniques of data collection. Cluster sampling was utilized to select schools in Embakasi South Sub-County. Simple random sampling was utilized to select adolescents in classes 5, 6 and 7; and 161 adolescents (87 females and 74 males) aged 10-14 years participated in the study. Structured questionnaires, 24-hour recall, and food frequency questionnaires were used to collect quantitative data. Anthropometric measurements were taken using calibrated standometers, weighing balance and MUAC tape to determine the nutritional status of the adolescents. The key informant interviews were conducted with 7 headteachers/ class teachers to collect qualitative data. Analysis of quantitative data was done using SPSS software version 23.0. Dietary and anthropometric data were analyzed using Nutrisurvey and ENA for SMART software. Pearson correlation was utilized to determine the relationship between the nutritional status and intake of energy-dense foods. The school heads consented on behalf of the parents of the adolescent. The study established a burden of malnutrition among adolescents in Nairobi County (13%) who are underweight, (5.7%) overweight, (4.3%) severely underweight, and (2.5%) obese. The average energy taken was 1610.4±686.4 kcal. The energy-dense foods which had a significant relationship with the nutritional status of the adolescents were: potato chips (r=0.044, p=0.045), doughnuts (r= -0.02, p = <0.001), pancakes (r= -0.001, p= 0.762), cheese (r= -0.107, p-value= 0.660), and Regular soft drink (r= - 0.147, p= 0.101). Qualitative findings indicated that doughnuts were frequently brought to school as snacks. In conclusion, a quarter of the adolescents interviewed were malnourished. The adolescents' nutritional status was influenced by the intake of some energy-dense diets and sociodemographic characteristics. There is a need to have nutrition education forums in schools and communities on the importance of nutrition to adolescents for better health.Item Comparison of Complementary Feeding and Nutrition Status between Children in Households with and those without Kitchen Gardens in Kakamega County, Kenya(Kenyatta University, 2024-03) Naandi, BilhaSub-optimal feeding and nutrition among infants and young children less than 59 months old are leading causes of under nutrition in least developed countries. Recent agri nutrition interventions, focused on kitchen gardening in developing countries revealed its impact on children’s complementary feeding and nutrition status, despite insufficient empirical evidence. This study aimed at comparing nutrition status and complementary feeding of 64 children aged between 6 and 23 months in households with and 64 others without kitchen gardens in Lurambi Sub-County, Kakamega County. The study used a comparative cross-sectional and analytical research design. The findings on nutritional status were compared with WHO, 2006 Child Growth Standards. Researcher administered interviews for selected study participants households, key informants and focus group discussions. Data on IYCF, nutrition assessment and kitchen gardening was elicited and analyzed using SPSS comparing variables from households across the groups. Mothers or caregivers socio-economic, and demographic characteristics with children 6 to 23 months, revealed a significant correlation between owning kitchen garden and crops grown, all (p-values<0.05). Crop production per year, Length for Age Z-scores (LAZ), amount consumed and sold were not normally distributed as was assessed by Shapiro Wilk test and were summarized into median and inter-quartile range (IQR). Logistic regression was used to compute Odds ratios for crops grown, with kitchen gardening households being four times more likely to grow kales (OR=4.058) and three times more likely to grow both jute mallow (OR=2.524) and cow peas (OR=3.246). Their utilization was compared across the two groups. Most households without kitchen gardens did not grow micronutrient rich vegetables. ENA for SMART software was used to generate Z scores from children’s anthropometric measurements. This was interpreted using WHO (2006) Child Growth Reference, with ˂-2 and ˃+2 z-scores as cut off points for under nourished and over-nourished children respectively. Severe stunting of Length for Age Z scores (LAZ) < -3 Z score among children was higher, n=64 (20.3%) than the other n=64 (6.3%) in those without than those with kitchen gardens respectively, with statistically significant difference in stunting levels (LAZ) across the groups (Mann-Whitney Z-test; p-value= 0.011).Minimum dietary diversity was the only index that was statistically significantly different across the groups, (p-value=0.013); with 71.9% and 53.1% meeting MDD in kitchen and non-kitchen gardening households respectively. Diet among children in households without kitchen gardens was mainly consisting of cereals (maize), obtained from their farms. Socio-economic characteristics of mothers and caregivers did not determine the adoption of kitchen gardening technologies. All households should be encouraged to practice kitchen gardening. Common crops grown in kitchen gardens were kales, cowpeas and yams that were mainly utilized as food in households. It was critical to sensitize the later households to practice crop diversification both for subsistence and nutritional implications. Majority of kitchen gardening households had a high crop diversity grown, which resulted in attaining a higher children proportion having MDD. This may mean that despite households accessing arable land, mothers and caregivers need education on the health implications of feeding their children on a less diverse diet. Stunting levels of children with kitchen gardens had lower stunting levels than their counterparts. The null hypotheses that there is no significant relationship between kitchen gardening and dietary diversity as well as no significant relationship between kitchen gardening and nutrition status of index children were therefore rejected. It is recommended that non-kitchen gardening households grow bio diverse, nutrient rich crops that contribute to optimal IYCF. Organizations implementing agricultural programs should collaborate with the Ministry of Health, focus on improving household nutrition, health and food security through agri- nutrition. A longitudinal study ought to be carried out to establish how optimal complementary feeding can be achieved among the children between 6 and 23 months old using nutrition sensitive agricultural programsItem Assessment of Infant and Young Child Feeding and Nutritional Status of Children 0-23 Months among Ilchamus Pastoralists in Baringo County, Kenya(Kenyatta University, 2024-04) Rotich, Joyline J.World Health Organization defines feeding practices of infants and young children as breastfeeding instantly after delivery and continuing exclusively for six months. Complementary feeding gradually from seven months with breastmilk till two years. Caregivers adhere to adequate infant and young child feeding practices to minimize child undernutrition. However, this is not always the case among the Ilchamus pastoralist community who live in the arid and semi-arid regions of Baringo County, facing challenges such as food insecurity and cattle theft. High prevalence of stunting (28.1%) and underweight (4.7%) have been reported among the community despite efforts to alleviate malnutrition in the area. Unfortunately, there is limited research on the feeding practices of children aged zero to twenty-three months in this community, resulting in a scarcity of information. Consequently, this study investigated the feeding patterns and nutritional status of children zero to twenty-three months among the Ilchamus pastoralists of Baringo County, Kenya. The researcher involved 206 caregivers with children zero to twenty-three months. A cross-sectional analytical study design was adopted. A multi-stage selection strategy was used to arrive at the study sample. Wards and locations were purposively selected. While proportionate selection for villages and households. The study was accomplished in Mukutani and Ilchamus Wards, Baringo County, Kenya. A structured questionnaire was utilized to gather descriptive data. The Statistical Packages for Social Sciences (SPSS) version 22 aided in data analysis. Nutritional status was determined by the mid-upper arm circumference, Weight-for-height, and Weight-for-age Z-score based on World Health Organization cut-offs. Descriptive statistics of infant and childcare characteristics were done using percentages and frequencies while association shown by chi-square and spearman’s correlation significant at p<0.05. Most caregivers had a primary level of education, 154(60.2%), and only seven (2.7%) had tertiary training. About 150(58.6%) were unemployed, and the majority, 142(55.5%), had an income of Ksh 5000- 10,000. About 207(80.9%) were married while 46(16.0%) were single. The prevalence of exclusive breastfeeding was 180 (70.3%), with 181(70.7%) initiating breasting within an hour after birth. About 35(13.7%) introduced other foods before age six. Minimum dietary diversity was at 3.8% for ages 6-8 months, 4.9% for 9-11 months, 8.2% for ages 12-17 months, and 9.2% among ages 18-23 months, and minimum meal frequency was three times a day. Prevalence of Wasting was at 35.6%, stunting (41.6%), and underweight (35.2%). The number of household members and household income are significantly associated with wasting (p<0.05). IYCF practices indicated a significant association with wasting (p<0.05). Stunting also showed a significant link between household members showed a significant association with stunting (p<0.05). In addition, household head, number of people in the household, and occupation of the household head showed a significant statistical association with underweight (p<0.05). Low uptake of optimal children's feeding practices contributes to their poor health and Nutritional status. The findings provide evidence of the importance of ensuring adequate feeding practices among Infants and young children to alleviate malnutrition. Thus, Baringo County and the National Government Ministry of Health in Kenya should enhance programs to improve nutrition education to advance maternal and child health.Item Adherence to Dietary Recommendations in the Management of Type 2 Diabetic Patients Attending Diabetic Clinic at Nyahururu County Referral Hospital, Kenya(Kenyatta University, 2024-02) Muketha, Maureen KarimiType 2 Diabetes is among the biggest contributors of deaths and morbidity worldwide. It’s also increasing steadily, and if not controlled, it will soon become an epidemic due to an increase in the ageing population and the number of obesity cases worldwide. This aggravates the existing burden on health systems especially in developing nations. Screening and diagnosis are based on clinical guidelines that encompass both clinical and laboratory parameters. There is presently no cure for the disease. However, adherence to dietary recommendations as advised by health care workers has proven to be a game changer in its management. Hence, the current study sets to unravel adherence to dietary recommendations in the management of Type 2 diabetic patients at Nyahururu County Referral Hospital. Blood glucose level was used in order to determine if the patient has adhered to dietary recommendations. The study was conducted between November 2022 and January 2023; and it adopted a cross sectional analytical design using the Perceived Dietary Adherence Questionnaire to collect information on the socio-demographic characteristics, behavioural characteristics, dietary diversity, adherence to dietary recommendations and the level of dietary awareness. The study also utilised Focus Group Discussions (FGDs) and Key Informant interviews (KIIs) to collect complementary qualitative data. Systematic random sampling was applied in the 152 participants; who attended the diabetic clinic at Nyahururu County Referral Hospital. The information and data collected was entered into SPSS Version 21.0 and analysed. Qualitative data was transcribed coded and analysed to bring out the emerging themes. The study found that the social demographic factors, behavioural characteristics and awareness influenced adherence to dietary recommendation among the diabetics’ patients attending Nyahururu diabetic clinic at Nyahururu County Referral Hospital. Analysis of the respondent BMI was classified under 4 categories of underweight, normal, overweight and obese. Most of the respondents had a normal BMI (55.3%), overweight (28.4%), obese (7.4%) while (9.2%) were underweight. It was also observed 91.5% of the respondents had fasting blood glucose of more than 7.0mmol/l or higher glucose levels at the time of this study. This means that most of the respondents had high and uncontrolled blood sugar levels. The mean energy intake per day was 2291.4±125.6 kcal for men and 2193.7±164.3 kcal for female. The patients’ demographic characteristics influenced the level of adherence to dietary recommendation among the diabetics’ patients attending Nyahururu diabetic clinic at Nyahururu County Referral Hospital. There existed a statistically important association between gender, income, level of education, marital status and the level of awareness with the diabetic patients’ adherence to dietary recommendations at α=0.05. On the other side, age was not found to have insignificant influence on the participants’ adherence to dietary recommendations at α=0.05. There also existed a statistically significant association between Physical exercise, smoking as well as presence of other disease and diabetic patients’ adherence to dietary recommendations at α=0.05. Taking alcohol, family diabetics history, duration lived with diabetes and self- care did not significantly influence participants’ adherence to dietary recommendations at α=0.05. The intervention should be based on gender, education status, marital status and income; the average sugar level in mean was higher than the sugar level in women thus implies that men had low observance of recommended dietary than female. The study recommends emphasis on the observations of physical exercise, smoking and presence of other disease. The Ministry of Health and stakeholders should emphasize regular community sensitization of communities on the dietary recommendations for diabetic patients through continuous nutrition advocacy.Item Parental Use of Reward and Punishment on Children’s Food Choices, Dietary Diversity and Nutritional Status in Kiambu County, Kenya(Kenyatta University, 2024-06) Mutuura, Caroline H. K.Determinants of food choices are many and include socio-cultural, socio-economic and environmental conditioning. The Kenyan population is made up of 47,564, 296 people of whom 1.4 % are the school going children aged 6-years- old in Juja Sub-County. Parental use of reward and punishment is a key to reinforcement or deterrence of food choices among children an aspect that affects nutritional status throughout. The purpose of this study was to establish the relationship between parental use of reward and punishment, on 6-year-old children and food choices, dietary diversity and nutritional status in Kiambu County, Kenya. A cross-sectional analytical research design was adopted on 384 parent-child pairs who were disproportionately sampled in Juja sub-county. A researcher administered questionnaire was used to collect data on demographics and socio-economic characteristics of the parents and children, parental use of reward and punishment on the study population, food choices and dietary diversity of the study children. Anthropometry was used to establish nutritional status of the study children. SРSS software version 26.0 and excel were used to analyze the data after coding. Anthropometric data was analyzed using WHO Anthro-Plus Survey Analyzer and compared to reference cut-off points for BMI-for-age (BAZ), weight-for-age (WAZ) and height-for-age (HAZ) Scores for the target age. Pearson’s correlation (r) was used to establish association of ratio data where a value of p< 0.05 or lower was significant and chi square (x2 ) used to establish association of categorical variables where the higher the score, the more likely the association between the variables. The boys were 48.0% while the girls were 52.0% with a mean age of 6.4± 0.1. Almost a half of the index children (45.1%) were born first. Mean household size was 5.0± 1.66 with maternal mean age at 34± 4.9 years and that of the fathers at 39± 4.8 years. Majority of the mothers (73.0%) and fathers (76.1%) had tertiary level of education with more fathers than mothers in the formal sector of employment and with a higher income. All (100%) of the children reported being rewarded by receiving incentives like praise words and special permissions (60.1%), favorite snacks (6.3%) and while majority of them (92.0%) reported being punished in multiple ways by the mothers when they refused to feed while a third of the fathers (61.0%) reported praising and gifting the study child to feed. Prevalence of stunting (6.9%), underweight (7.1%), wasting (7.2%), overweight (16.4%) and obesity (11.7%) was observed in the study population. A positive strong significant relationship (P≤0.05, x 2 =5.2) between age of the mothers and punishment was noted and also between married mothers and shouting threats, grounding, inflicting pain & withdrawal of privileges (P≤0.05, x 2 =9.6). More parents with tertiary education (74.6%) and higher incomes (40.5%) gifted and gave special permissions. Gift, praise & special permissions had a stronger positive relationship to food choices (P≤0.06, x 2 =4.33) and nutritional status (P≤0.04, x 2 =5.9). Food choices had a strong positive relationship to nutritional status (P≤0.05) and so did dietary diversity (P≤0.6). Sensitization of parents on the use of parental reward and punishment on children’s food choice and nutritional status came out as an area of interest. The findings of the study will contribute to the achievement of the third sustainable development goal.Item Weight Loss Methods among Overweight and Obese Bank Staff in Selected Commercial Banks in Nairobi City: County, Kenya(Kenyatta University, 2023-05) Macharia, Jacqueline; Peter Chege; Ann MunyakaAbstractItem Determination of Vitamin Concentration in Fresh, Sun and Oven Dried Selected Edible Insects Collected From Siaya County, Kenya(Kenyatta University, 2023-02) Muya, Virginia Wambui; Hudson Nyambaka; Chrysantus Mbi TangaAbststractItem Antioxidant Retention Acceptability in Solar-Dried Mushrooms and Acceptability of Mushroom Millet Porridge Blend among HIV Patients in Nakuru County Referral Hospital, Kenya(Kenyatta University, 2023-11) Masiko, Bosire Miriam; Ann Munyuka; Juliana KiioTh_e rolg of mushrooms in preventing and treating illness and promoting quality of life has gained increased awareness especially due to their high antioxidant content. Antioxidants are necessary for body protection against oxidative stress especially among people with lowered immune system, such as People Living with HIV/AIDS (PLWHAs). There are limited options ot: nutritional therapeutic foods available for use by PLWHAs. Millet is an Under}mllze.d indigenous crop in Kenya whose nutrient profile can be improved through blt_ndm.g with other foods. The purpose of this study was to establish the antioxidant (Vltamm E, Vitamin C, B-carotene and Total Phenolic Content) concentration and retention in fresh' .and solar-dried oyster mushrooms (Pleurotus ostreatus) and assess the acceptability of finger millet (Eleusine Coracana) porridge enriched with oyster mushroom among PLWHASs. The study adopted an experimental design with fresh mushrooms and pure millet flour as the control samples and mushroom enriched millet flour as the experimental samples. Fresh mushrooms were purchased in Juja sub-county, Kenya, transported using cool boxes and refrigerated at 4°C in the Kenyatta University food chemistry laboratory. Millet samples were purchased from markets within Nairobi County, Kenya and transported and stored in hermetic bags. B-carotene and Total Phenolic Content of mushrooms and millet were analyzed using UV-VIS spectrophotometry at 450nm and 765nm respectively. Vitamin C and Vitamin E content were analyzed using reverse-phase high Pressure liquid chromatography (HPLC). Sensory acceptability of mushroom-millet porridge was determined using a S-point hedonic scale questionnaire administered to 30 randomly selected participants (PLWHAs) from Nakuru County Referral Hospital. Independent T-tests and Analysis of Variance (ANOVA) were used to analyze nutrient content and sensory scores. The antioxidant nutrient content of fresh and solar dried mushrooms were: B-carotene- 13.73 + 0.02 mg/100g dw, 1.21 + 0.00 mg/100g dw ; Vitamin E- 23.23 + 2.12 mg/100g dw, 0.96 + 1.18 mg/100g dw; Vitamin C 37.25 + 0.32 mg/100g dw, 5.60 + 0.12 mg/100g dw and TPC 36.48 + 1.50 mg/100g dw, 21.55 + 0.24 mg/100g dw respectively. Blanching the mushrooms before solar drying increased the retention rate of the nutrient antioxidants in the solar dried mushrooms. There was a significant difference in the antioxidant content of fresh mushroom and solar dried mushrooms in all the tested nutrients (p < 0.05). Enriching millet flour with mushroom powder significantly increased p-carotene, Vitamin C and TPC concentrations (p < 0.05). There were significant differences between control porridge and mushroom enriched millet porridges on all sensory attributes apart from color (p < 0.05). The unblanched mushroom: millet porridge (60:40) blend was rated the poorest (2.97 + 1.47) in all the sensory attributes. This study’s findings demonstrate that oyster mushrooms are rich in antioxidants. However, solar drying the mushrooms without blanching significantly lowers the levels of the antioxidants. This study established that porridge made from millet flour enriched with mushroom is rich in -carotene, Vitamin C and TPC; and is acceptable among PLWHAs. The consumption of porridge made from millet-mushroom blended flour should be promoted among PLWHAs not only because of protein content but also because of antioxidant content. Findings from this study are relevant to nutritionists, farmers, and policy makers as it shows the potential of mushrooms in enhancing diets, promoting health and income generation.Item Socio-Economic and Demographic Determinants of Dietary Practices among Young Adults (19-24 Years) Attending Commercial Colleges in Nairobi’s Central Business District, Kenya(kenyatta university, 2023-09) Mwanthi, Florence Mwende; Irene Ogada; Zandile Mchiza; Sophie OcholaAttending a college or university is an experience that is stressful to many young adults as they get introduced to an unfamiliar food environment full of economic constraints. As a result, they may develop poor dietary practices as a way of coping with this stressful environment. Evidence suggests that college students consume sub-optimal diets, hence, they tend to present with the triple burden of malnutrition. There is minimal data on the dietary practices of students attending commercial colleges in Kenya. The purpose of this study was to explore the socio economic and demographic factors related to dietary practices as well as health and nutrition status of commercial college students 19-24 years of age. A sample of 385 students was selected using proportionate stratified sampling coming from 10 purposively picked colleges in Nairobi's Central Business District (NCBD). Data was collected using a pre-tested researcher-administered semi-structured questionnaire that consisted of socio-demographic variables, a 24-hour dietary recall and a food frequency questionnaire. Key informant interview guides and observation checklists were also used to collect information on the food frequently consumed by the participants, food prices and types of food outlets available in the colleges. Food-related data analyses were conducted using the South African Medical Research Council (SA-MRC) Food Finder 111 (2016) package while the general data was analysed using the SPSS version 24 (2017) package. Statistical significance was set at p <0.05. Overall, the mean energy, protein, fat, carbohydrate, added sugar, dietary fibre and sodium intake were respectively 5347kJ±, 138±132g, 138g±132g, 57g±50g, 172g±203g, 16g±15g, 12g±15g and 1244mg±1551mg. Females had higher BMI indices than males (22.67kg/m2 versus 21.48kg/m2, p=0.010). They also had significant waist-to-height ratios (WTHRs) when compared to males (0.49 versus 0.47 p=0.005). Males on the other hand had significant waist–to-hip ratios (WHRs) than females (0.85 versus 0.81, p<0.001). In this case, being male decreased the likelihood of the students having BMI ≥ 25kg/m2 (r= 0.203, p<0.001); while having 2 children or more and attending college for 2 years or more increased the likelihood of the students having BMI ≥ 25kg/m2 (r=7.682, p=0.002 and r= 1.710, p=0.044). The socio-economic determinants of dietary intake were; being a food decision maker, source of water and type of cooking fuel while socio-economic determinants of nutritional status were the source of income and monthly food expenditure. Furthermore, the demographic determinants of dietary intake were the tribe students belonged to, their year of study and the number of children and family size the students had while the socio-demographic determinants of nutritional status were age, sex, and religion. No dietary intake factors were significantly associated with the BMI ≥ 25kg/m2. The food outlets were found to be selling mostly high fat and sugary foods and snacks. The commercial colleges did not have guidelines on the type and nutritional quality of food that should be sold. We therefore recommend that the colleges liaise with food outlets to encourage the sales of healthy food and consult nutrition experts to facilitate provision of information to the students regarding healthy food. The information from this research will therefore be useful to tertiary institutions and stakeholders such as the Ministry of Higher Education, Science and Technology, Ministry of Health, colleges in the Nairobi Central Business District and relevant Non-Governmental Organisations on the current dietary intake and nutritional status of students in Nairobi CBD.Item In Vitro Bio-Accessibility and Consumer Acceptability of Zinc Bio-Fortified Mushroom-Heat and Moisture Treated Millet Complementary Porridge in Vihiga County, Kenya(Kenyatta University, 2023-10) Karenya, Susan; Ann Munyaka; Fredrick MusiebaZinc is a crucial micronutrient for human physiological processes like infant growth, reproductive health, immune system function, and vision. Zinc deficiency can lead to poor growth, intellectual impairment, prenatal complications, and increased morbidity and mortality. Zinc supplementation or food fortification is recommended to decrease the severity and incidence of severe childhood infectious diseases in populations at risk for zinc deficiency. Given their nutrient density, vital mineral content, and human-promoting compounds, edible mushrooms in this case have great potential for improving the nutritional value of usually carbohydrate-rich diets. There is limited information on the bio-accessibility of zinc from bio-fortified mushrooms when added to heat and moisture treated finger millet porridge. This study was conducted to determine whether heat- and moisture-treated finger millet combined with biofortified mushroom powder effectively increased zinc bio-accessibility and its acceptability. This study adopted a completely randomized experimental design. The study evaluated the effect of zinc supplementation on the zinc content of oyster mushroom fruit-bodies grown on straws with varying concentrations of zinc sulfate. The mushrooms were harvested, dried, and milled into fine powder and those with the highest zinc were mixed with HMT finger millet in different ratios of 100:0 (control), 95:5, 90:10, 85:15, and 80:20. The total zinc content of biofortified mushroom and zinc bio-accessibility in millet-mushroom flour blends were determined using atomic absorption spectrometry and a simulation method of gastro intestinal digestion, respectively. In addition, 25 semi-trained panelists, including mothers and caregivers aged 18-45, evaluated porridges made from HMT finger millet-mushroom composite flours at a postnatal clinic. Adding zinc to growth substrates had a significant (p˂0.05) effect on zinc content in mushroom. Zinc levels. Substrates without ZnSO4 produced mushrooms containing 8.9 mg Zinc, which increased by 30.9% when 600 mg ZnSO4 was added. Furthermore, HMT finger millet porridge without mushrooms had a Phytic acid: zinc molar ratio of 60.3, which decreased to 34 when 20% (w/w) mushroom powder proportions were added. Despite having the highest bio-accessible zinc with the least effect on texture and appearance, a 20% mushroom proportion in HMT finger millet porridge considerably compromised the taste, aroma and general consumer acceptability. Bio-accessibility of zinc was increased from 16.57% to 21.653% when blended with 20% mushroom powder. Blending HMT finger millet flour with mushroom powder improved zinc bio-accessibility of the porridge. However, when added beyond a certain limit, mushroom reduced organoleptic qualities of the porridge, which affected overall consumer acceptance. The study recommends, therefore, that mushroom powder be added to finger millet flour in the appropriate proportions to enhance nutritional and health benefits of porridge while minimizing possible negative impacts on sensory properties.Item Lifestyle Habits and Nutritional Status of Undergraduate Students at Kenyatta University, Nairobi City County, Kenya(Kenyatta University, 2023-09) Ndung’u, Joseph Mburu; Judith Waudo; Joseph KobiaSince 1975, the prevalence of obesity has nearly tripled. About 39% of adults worldwide (1.9 billion) were overweight and obese by the year 2016. Lifestyle habits such as eating habits, physical activity, smoking, alcohol intake and sleep duration have been associated with obesity. The transition from secondary to tertiary education comes with increased liberty and choices in lifestyle habits. The study’s purpose was to establish a relationship between demographic, socio-economic status, and lifestyle habits on the nutritional status of undergraduate students at Kenyatta University in Nairobi County, Kenya. The study design was cross-sectional analytical while the study location was Kenyatta University. The sample population was 260 students drawn from 17 schools. Data was collected using a researcher-administered questionnaire. Data analysis was conducted using SPSS version 24.0. About 249 respondents participated in the study. About 79.9%, 8%, and 12% had neutral eating habits, unhealthy eating habits and healthy eating habits. Just under a quarter (24.1%) of the respondents were physically active while 75.9% were physically inactive. A low prevalence of tobacco smoking was reported. All smokers were light smokers. The average sleep duration was 7.88 ± 1.308 hours per day. About, 56.6%, 28.1% and 15.3% reported they sleep between 7-8 hours, ≥9 hours and <7 hours of sleep per day. Close to a third (31.3%) reported alcohol intake. Based on drinks per occasion, 73.1 and 26.9% of the alcohol users were moderate and binge alcohol users respectively. Based on Body Mass Index, 8.4%, 67.5%, 16.5% and 7.6% of the respondents were underweight, normal, overweight and obese respectively. However, based on Waist Circumference, 21.7% had abdominal obesity while 78.3% had no abdominal obesity. There was a significant relationship between residential status and eating habits. Only sex and age showed a significant relationship with smoking status. Significant associations between demographic and socio-economic characteristics were reported. Advanced age, fourth year of study and source of meals were significantly associated with BMI. Only sex, year of study and residence status were significantly associated with Waist Circumference. Associations between lifestyle habits and nutritional status, consumption of fast foods was significantly associated with Furthermore, mean eating habits scores had a significant association with waist circumference. The study findings showed that more males than females engaged in harmful alcohol intake and smoked tobacco while more females than males were physically inactive and reported higher BMI and waist circumference. These findings can be used to inform gender- specific strategies and interventions to prevent smoking, harmful alcohol intake, physical inactivity, overweight, obesity and abdominal obesity. Studies on physical activity and nutritional status using objective methods of assessing physical activities should be conducted.Item Dietary Intake, Comorbidities and Nutrition Status of Maintenance Hemodialysis Patients Attending Renal Unit Kenyatta National Hospital, Kenya(Kenyatta University, 2023-10) Maina, Rachael Muthoni; Judith Waudo; Regina KamuhuChronic Kidney Disease globally has been worrying as it has risen to being the 17th leading cause of mortality in 2015. It is approximated that in Kenya 4% are affected which may not be the true burden as the country lacks national registries. Diabetes and hypertension, the major etiologies of kidney failure are epidemic in Kenya. Although there are good guidelines by the Kidney Disease Outcome Quality Initiative on the recommended dietary energy and protein intake, hemodialysis patients are unable to meet the targets because of the dietary restrictions to prevent mineral imbalances, low socioeconomic status and presence of comorbidities. Protein Energy Wasting, an indication of low nutrition status of patients is seen in 18-75% of hemodialysis patients. This called the need to evaluate, do the hemodialysis patients in Kenya meet the required dietary intake, what the comorbidities are affecting them and what is their nutrition status? Therefore, the objective of the present study was to know the dietary intake, comorbidities and nutrition status of hemodialysis patients. A cross-sectional analytical study was conducted among 84 respondents undergoing hemodialysis present during the month of November 2021 at Kenyatta National Hospital renal unit. They were selected using consecutive purposive sampling. Data collection was done using a digitalized questionnaire for the socio-demographic and economic factors, presence of comorbidities, a 7-point subjective global assessment scale to assess the nutrition status, two 24hr dietary recalls both on non-dialysis and dialysis days, Individual dietary diversity score from the average 24hr recall, a 7-day food frequency questionnaire and nutrition supplement consumption to evaluate the nutrient intake. The researcher also conducted a focus group discussion with 12 dialysis patients and caregivers to know the factors that caused proper and poor adherence to diet. Quantitative data were analyzed using SPSS version 25 and Updated Nutri-survey 2018 while qualitative content, hand-coding and presented in form of themes. The mean age was 42.24±16.6 years with 41% being male. About a third 38.1% were employed and a majority 66.7% relied on family for financial support. Diabetes Mellitus (20.2%), present or past malignancy (4.8%) and cardiovascular illness (4.8%) were comorbidities present. The average energy intake was 14.738±8.46 kcals/ kg body weight/ day lower than endorsed 30-35kcal/kg/day. There was no significant difference (t=.990, p-value=0.325) in energy intake on dialysis and non-dialysis day. The mean protein intake was 0.43g/kg/day way lower than advocated 1.2g/kg/day. The mean daily micronutrients intake was as follows: sodium, 904.54±805.27mg; potassium 973.57±595.2mg; phosphorus, 549.835±401.91mg, calcium, 203.78±127.325mg; zinc 4.92±4.02mg; vitamin C, 42.83±31.58mg; and vitamin B6, 0.815±0.685mg. The average 7-point Subjective Global Assessment score was 4.95±0.963 with 70% having protein-energy wasting (score ≤ 5). Employment (P =.007) and education level (P= .035) were found to be significantly associated with nutrition status. There was no significant relationship noted between average energy intake (P=0.446), average protein intake (P=0.16) and nutrition status. Comorbidities had no significant association with nutrition status(P=.221). Fear of respiratory distress and hope for better health caused adhere to nutrition counselling. NHIF cover not inclusive of nutrition service charges, low purchasing power and constant delays due to machine breakdown and water issues caused poor dietary adherence. This study reveals that there was low dietary intake and moderate protein energy wasting. It can be curbed by proper and continuous nutrition counseling by the renal nutritionist. Ministry of Health, National and County Hospital heads to ensure full NHIF medical cover inclusive of laboratory biochemical tests and nutrition services for continuous nutrition status review.Item Knowledge, Attitude and Acceptability of Human Breast Milk Banking among Lactating Mothers at Pumwani Maternity Hospital, Nairobi City County, Kenya(kenyatta university, 2023) Mati, Christine Mwende; Peter Chege; Joseph KobiaHuman breast milk is the most critical feeding option for newborns and infants. The World Health Organization recommends infant exclusive breast feeding for the initial six months of life. In the instance that breastfeeding cannot be seamlessly achieved or initiated; the WHO recommends the donation and use of human breast milk as the best of other replacement feeding options. In Kenya, the first human milk bank was started up in 2019 at Pumwani Maternity Hospital in Nairobi City County, with the aim of filling this gap in breastfeeding practices for the benefit of infants. The purpose of this study was to establish the knowledge, attitude and acceptability of human breast milk banking among lactating mothers at Pumwani Maternity Hospital, Nairobi City County, Kenya. A cross-sectional descriptive study design approach was utilized for the study, with systematic sampling and sample random sampling methods applied to gain 403 lactating mothers as the study respondents. A structured and consolidated, researcher-administered questionnaire, key informant interviews and focus group discussions were used to collect the data. The collected qualitative data was analyzed using the Statistical Package for Social Sciences (SPSS) version 21.0. Chi-Square tests were used to determine association and the Fisher’s Exact test was applied to assess the null hypotheses for variables where the frequencies were less than five. Results with p-values less than 0.05 were said to be statistically significant. For qualitative data, content analysis was conducted. The results indicated that the mean age of lactating mothers visiting Pumwani Maternity Hospital was 30.8 ± 6.9 years. A majority (51.7%) of the lactating mothers had adequate knowledge on human donor breast milk banking with 48% of them having a basic knowledge on the concept of human breast milk donation. A majority (57.1%) of the lactating mothers reported positive attitudes towards human breast milk donation and banking. However, human breast milk donation and banking was only acceptable to 36.4% of the lactating mothers, and was unacceptable to 24.8% of them. 32.7% of the participants were uncertain about their acceptability of donor human breast milk banking. A significant relationship (χ2==55.9671; p-value<0.00001) was found to exist between the lactating mothers’ age and their acceptability of donor human breast milk banking. Their acceptability of donor human breast milk banking was also significantly associated with their marital status (χ2 =43.3383; df 2); and their level of education (χ2=11.78; df 2; p-value=.019046). However, it was found that there was no significant relationship between the lactating mothers’ acceptability of donor human breast milk banking and their employment status or occupation ((χ2=1.1567, p=.5608]). The researcher concluded that knowledge and attitudes of lactating mothers are co-dependent in influencing their acceptability of human breast milk donation and banking. It is recommended that efforts to improve knowledge levels of lactating women on the concept and availability of human breast milk donation and banking facilities be employed within Pumwani Maternity Hospital and Nairobi City County. The findings of this study may therefore be useful to stakeholders within the Nairobi City County, and the Human Breast Milk Banking coordinators at Pumwani Maternity Hospital, in the effort of strengthening gaps in infant feeding.Item Antioxidant Retention in Solar-Dried Mushrooms and Acceptability of Mushroom Millet Porridge Blend among HIV Patients in Nakuru County Referral Hospital, Kenya(Kenyatta University, 2023) Bosire, Miriam Masiko; Ann Munyaka; Juliana KiioThe role of mushrooms in preventing and treating illness and promoting quality of life has gained increased awareness especially due to their high antioxidant content. Antioxidants are necessary for body protection against oxidative stress especially among people with lowered immune system, such as People Living with HIV/AIDS (PLWHAs). There are limited options of nutritional therapeutic foods available for use by PLWHAs. Millet is an underutilized indigenous crop in Kenya whose nutrient profile can be improved through blending with other foods. The purpose of this study was to establish the antioxidant (Vitamin E, Vitamin C, β-carotene and Total Phenolic Content) concentration and retention in fresh and solar-dried oyster mushrooms (Pleurotus ostreatus) and assess the acceptability of finger millet (Eleusine Coracana) porridge enriched with oyster mushroom among PLWHAs. The study adopted an experimental design with fresh mushrooms and pure millet flour as the control samples and mushroom enriched millet flour as the experimental samples. Fresh mushrooms were purchased in Juja sub-county, Kenya, transported using cool boxes and refrigerated at 4ºC in the Kenyatta University food chemistry laboratory. Millet samples were purchased from markets within Nairobi County, Kenya and transported and stored in hermetic bags. β-carotene and Total Phenolic Content of mushrooms and millet were analyzed using UV-VIS spectrophotometry at 450nm and 765nm respectively. Vitamin C and Vitamin E content were analyzed using reverse-phase high Pressure liquid chromatography (HPLC). Sensory acceptability of mushroom-millet porridge was determined using a 5-point hedonic scale questionnaire administered to 30 randomly selected participants (PLWHAs) from Nakuru County Referral Hospital. Independent T-tests and Analysis of Variance (ANOVA) were used to analyze nutrient content and sensory scores. The antioxidant nutrient content of fresh and solar dried mushrooms were: β-carotene- 13.73 ± 0.02 mg/100g dw, 1.21 ± 0.00 mg/100g dw ; Vitamin E- 23.23 ± 2.12 mg/100g dw, 0.96 ± 1.18 mg/100g dw; Vitamin C 37.25 ± 0.32 mg/100g dw, 5.60 ± 0.12 mg/100g dw and TPC 36.48 ± 1.50 mg/100g dw, 21.55 ± 0.24 mg/100g dw respectively. Blanching the mushrooms before solar drying increased the retention rate of the nutrient antioxidants in the solar dried mushrooms. There was a significant difference in the antioxidant content of fresh mushroom and solar dried mushrooms in all the tested nutrients (p ≤ 0.05). Enriching millet flour with mushroom powder significantly increased β-carotene, Vitamin C and TPC concentrations (p ≤ 0.05). There were significant differences between control porridge and mushroom enriched millet porridges on all sensory attributes apart from color (p ≤ 0.05). The unblanched mushroom: millet porridge (60:40) blend was rated the poorest (2.97 ± 1.47) in all the sensory attributes. This study’s findings demonstrate that oyster mushrooms are rich in antioxidants. However, solar drying the mushrooms without blanching significantly lowers the levels of the antioxidants. This study established that porridge made from millet flour enriched with mushroom is rich in β-carotene, Vitamin C and TPC; and is acceptable among PLWHAs. The consumption of porridge made from millet-mushroom blended flour should be promoted among PLWHAs not only because of protein content but also because of antioxidant content. Findings from this study are relevant to nutritionists, farmers, and policy makers as it shows the potential of mushrooms in enhancing diets, promoting health and income generation.Item Women’s Participation in Household Decision-Making, Dietary Diversity and Nutritional Status of Children in Smallholder Farming Households in Kakamega County, Kenya(Kenyatta University, 2023-08) Musau, Kelvin; Elizabeth Kuria; Ann MunyakaAddressing malnutrition in under-five children remains a global priority due to its association with long-term adverse health and economic implications at all levels in society. While huge disparities in progress towards nutrition targets for SDGs exist across the globe, sub-Saharan Africa particularly lags despite the intensity of nutrition and health programmes ongoing in the region. There is a need to explore new paradigms in the etiology and epidemiology of child malnutrition paying attention to the socio-economic and cultural dynamics associated with unique contexts. Evidence shows that allocation of resources towards a child's health and nutrition inputs like child feeding and treatment hung on household decision-making patterns. However, there is limited evidence on the level of women’s participation in household decision-making and its implication on the nutritional and health outcomes in children. This study adopted a cross-sectional analytical design to determine women’s participation in household decision-making and its influence on nutritional status of children aged 6-59 months of age in rural smallholder farmer households in Kakamega County. Lugari Sub-County was purposively chosen based on the high prevalence of malnutrition and large population of smallholder farmers. Simple random sampling method was used to select Chevaywa out of the 6 Wards making up Lugari Sub-County while 330 households randomly selected from a sampling frame of smallholder farming households with children 6-59 months old from the 3 Sub–locations in the ward participated. A researcher-administered questionnaire was used to collect data on demographic and socio-economic characteristics of the participants, household decision-making patterns, child dietary diversity and nutrition status. Data collected was coded and analyzed using STATA version 15.1 and presented using measures of central tendency, frequency tables and graphs. Regression analysis was used to model the relationship between predictor variables (socio-economic characteristics, level of women’s participation in household decision making, child dietary diversity) and the outcome variable (nutritional status). Significance was tested at α=0.05, 95% confidence interval. The findings show that in majority (90%) of the households, decisions were predominantly made jointly by the women and their spouses. The prevalence of wasting, stunting and underweight was 4.5%, 20.6% and 6.4%, respectively. Women who made fewer unilateral household decisions (<=50%), were more likely to have wasted (odds ratio=1.38, p=0.003), stunted (=odds ratio= 1.77, p=0.010), and underweight (= odds ratio =1.11, p=0.044) children compared to those who made > 50% unilateral decisions. Based on the study findings, participation of women in household decision-making is critical to the realization of optimal nutritional outcomes in under-five children in rural smallholder farming contexts as it enhances dietary diversity and nutritional status of children aged 6-59 months. Cognizant of the importance of women in decision making, policies should that seek to empower women socio-economically should be promoted at all levels in the society. Similarly, nutrition programmes implementers should integrate social behavior change and communication interventions in their projects to address culturally propagated and encouraged gender stereotypes and biases that deny women the decisional space at the household level.Item Feeding practices, morbidity, and nutrition status of adolescent street children 10-17 years in Nairobi city county, Kenya(Kenyatta University, 2023-11) Machocho, Jomo SofiaUNICEF approximates that there are millions of street children globally, and a majority of them live in low- and middle-income countries. According to the 2018 National Census of Street Families, 15,347 adolescents are street inhabitants, and approximately 5,046 of live in the streets of Nairobi. Despite this high population, research on the feeding practices, morbidity, and nutrition status of adolescent street children is very limited. The purpose of this study was to determine the feeding practices, morbidity, and nutrition status of adolescent street children 10-17 years in Nairobi City County. Analytical cross-sectional design was used for this study. The study had 248 study participants (89 females and 159 males). The sampling was done by cluster sampling. Five clusters were randomly selected; Jeevanjee Gardens, Uhuru Park, Toi Market, Muthurwa Market, and Gikomba Market. Everyone who met the inclusion criteria in the randomly selected clusters took part in the study. Data was collected using anthropometric tools, interviewer-administered questionnaires, and focus group discussions. Anthropometric data was analysed using WHO AnthroPlus software, quantitative data was analysed using the 25th version of Statistical Package for Social Science (SPSS) software, and qualitative data was analysed using NVivo 1.0 software. A majority (40.3%) of the study participants had two meals per day. The participants lacked dietary diversity. Majority (75.8%) of the respondents had been sick in the past two weeks prior to the data collection. Over half (54.8%) of the respondents had experienced gastrointestinal (GIT) infection. A few of the respondents were malnourished as 3.2% had severe thinness, 8.1% had thinness, 4.8% were overweight, 7.7% were stunted, and 2.8% were severely stunted. The rate of thinness in the respondents was more than the acceptable levels of wasting recommended by WHO in developing countries (<2%). The cases of under-nutrition were more in adolescent street males than adolescent street females. The study showed that there is a significant relationship between feeding practices and nutrition status of adolescent street children 10-17 years in Nairobi City. The study also showed that there is a significant relationship between morbidity and nutrition status of adolescent street children 10-17 years in Nairobi City County. The findings revealed that the nutrition status of street children is influenced by their feeding practices and morbidity. The county government is planning to construct a rehabilitation centre and develop a policy with programmes for the street children. While waiting for the street children to be rehabilitated, the county government should strengthen the implementation of programmes aimed at improving the feeding practices and health status of street children. Specific feeding and treatment programmes for street children should also be included in the proposed street children rehabilitation policy. To determine effective strategies that can be used to improve the nutrition status of adolescent street children, a longitudinal intervention study should be done.