Dietary Practices, Body Image, Physical Activity Level and Nutrition Status of Postpartum Women in Nairobi City County, Kenya
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The global prevalence of overweight and obesity has increased from 6.4% in 1980, 12% in 2008 to 39% in 2014. These statistics show rising prevalence of overweight among women of reproductive age in many regions including Sub-Sahara Africa. Studies indicate sub-optimal dietary intake, body dissatisfaction, less physical activity levels and increase of body weight at postpartum period as the main contributors. It is also emerging from research done mainly in western countries that African women tend to have a more positive perception of overweight and obese bodies as compared to women of other races. Kenya’s Nairobi County as reported by Kenya Health Demographic Surveys has had an increase of prevalence of overweight and obesity among women of reproductive age from 41% in 2008 to 48% in 2014. Many studies have been conducted on women’s nutrition in Africa and Sub-Sahara region but few have focused on postpartum dietary practices, physical activity and body image. This study therefore determined dietary practices, body image, physical activity level and nutrition status of postpartum women in Kasarani sub-county. The study was cross-sectional analytical with quantitative approaches in data collection, analysis and presentation. The sample size consisted of randomly selected 433 postpartum women with infants 6-9 months of age. Dietary practices were determined by use of 24Hr dietary recall and Postpartum Dietary Practices Questionnaire while body image was determined by use of the Stunkard Figure Scale (SFS). Nutrition status was determined by Body Mass Index (BMI), waist circumference (WC) and waist to hip ratio (WHR) as classified by WHO. Physical activity level (PAL) was determined using Metabolic Equivalent of Task values (MET values) by WHO. Analysis of data was done by use of Statistical Package for Social Sciences (SPSS) software version 20. Dietary intake data was analysed using the Nutri-survey software. Frequencies, percentage, proportion, mean and standard deviations were used to describe data on dietary practices, body image, PAL and nutrition status categories as well as demographic and socio-economic characteristics. Bi-variate analysis was used to analyze associations between nutrition status and dietary practices. This study used multiple regression analysis to analyze relationship among dietary practices, body image, PAL and nutrition status. The criterion for statistical significance was a p-value of <0.05. Mean number of main meals, snacks and energy intake were 3 ± 0.22, 1 ± 0.92 and 2589.29 ± 580.6, respectively for the recalled day. Foods increased at postpartum included vegetables (66.7%), sugar sweetened hot beverages (87.6%), water (91.2%), pulses (49.2%) and cereals (47.8%). More mothers (64.4%) reported to have eaten more quantity of food at postpartum compared to pregnancy period. Food chosen was mainly due to affordability (75.1%). Sources of nutritional decisions were own knowledge (32.6%), health professionals (27.9%) and friends/relatives advice (29.6%). Only 31.4% mothers were satisfied with their bodies and 43.9% desired to lose weight. Majority (86.8%) of the mothers met the recommended WHO’s MET values for activity level. The mean WHR was 0.86 ± 0.082, WC was 85.99 ±13.34 cm while BMI was 26.29 ± 5.06. Dietary practices, body image and physical activity level significantly predicted nutrition status for the postpartum women. Findings of this study will be useful to the Ministry of Health and other stakeholders involved in developing and regulating maternal nutrition guidelines as they may influence policy review and practice in maternal nutrition and care at postpartum.