Complementary feeding practices and nutritional status of children 6-23 months in Kitui County, Kenya

Objectives: Inappropriate complementary feeding practices among  children aged 6-23 months is major cause of under nutrition. There is scarce information on the relationship between complementary feeding practices and nutritional status. This study aimed to determine the factors contributing to the complementary feeding practices and the nutritional status of children aged 6 -23 months.Methodology and Results: A randomly selected sample of 201 children aged 6-23 months was investigated using a cross sectional analytical design in four randomly selected sub-counties in Kitui County. Data wereanalyzed using ENA for SMART for nutrition status, Nutri-survey for dietary intake and SPSS. Results showed that most caregivers (70.6%) had attained primary level education. Majority of respondents (69.2%) had lowlevels of income. The average number of meals consumed per day was 4.1 ± 0.01. The main foods consumed were carbohydrates with little  consumption of fruits and vegetables. The levels of wasting, stunting andunderweight were 7.0%, 22.9% and 10.9%, respectively.Conclusions and application of findings: The complementary feeding practices were inadequate to meet the macronutrient and micronutrients needs of the children. The foods lacked variety, children took fewer meals per day and key foods were consumed less frequently than expected. The low food production in the semi- arid area coupled with low income could be associated with the food insecurity and consequently to the quality, quantity and diversity of the foods consumed by the children. The levels of malnutrition were relatively high for these children aged 6-23 months and this could be attributed to food insecurity indicated by low dietary diversity. The study noted a significant relationship between complementary feeding practices and nutritional status. The study recommends use of locally available, affordable and variety of foods to improve nutrient content of complementary foods. The study recommends agricultural interventions to enhance the nutritional content of complementary foods. Nutrition education on appropriate Infant and Young Child Feeding among mothers is essential.Key words: Complementary feeding practices, Nutritional status, children under 6-23 month

Effectiveness of nutrition education on nutrient intake and pregnancy outcomes in Migori County, Western Kenya

Maternal nutrition is critical as it lays fundamental foundation for the successful outcome of pregnancy. Kenya’s high rates of under nutrition among  women of reproductive age are due to sub-optimal feeding practices, inadequate nutrient intake and insufficient knowledge on nutritionally  adequate diets leading to poor pregnancy outcomes. This study assessed nutrient intakes and pregnancy outcomes among pregnant  women of about 22 weeks gestation exposed to a psycho-educational nutrition initiative in Migori County. A prospective cohort study design and  simple random sampling was used to obtain a sample of 150 pregnant women who were enrolled into the Intervention Study. Data was collected  using 24-hour dietary recall, anthropometric measurements and health records and was analysed by Nutri-Survey and SPSS and tested using t-tests  and regression model. The mean of macronutrient intakes at baseline were 1613±439 kcal for energy, protein 62.6±24.6 g, carbohydrates 245±7 g,  fat 41±2 g and after the intervention, mean energy intake was 2159±309 Kcal, protein 86±2 g, carbohydrates 312±6 g and fat 61±3 g. There was a  significant improvement in the intakes for all the macronutrients after four months exposure to the intervention. The mean micronutrient intakes by  the women at baseline were, vitamin A, 1255±2131 μg, folic acid, 197±7 μg, vitamin C 67±4 mg, calcium 300±141 mg, iron 115±3 mg and zinc  12±4 mg. The mean intakes after the intervention were, Vitamin A 1750±3560 μg, folic acid 249±7μg, vitamin C 90±6 mg, calcium 442±2 mg, iron  15±3 mg and zinc 16±4 mg. There was a significant increase in intake of all micronutrients after the intervention. Mean gestation age at recruitment  was 21 weeks, gestation age at delivery was 37.7 weeks. The mean birth weight was 3098±5 grams. Babies born before 37 weeks gestation were  32.6 % while 67.4 % were born at ≥37 weeks gestation. Coefficients of determination (R2) from the regression model showed that there were  positive significant effects of nutrition knowledge obtained from the psychoeducational initiative on nutrient intake after the intervention and on  pregnancy outcomes. The intervention had a significant effect on nutrient intake and pregnancy outcomes and should be strengthened in the  healthcare system to improve nutrition knowledge and dietary practices for enhanced nutrient intakes and pregnancy outcomes

Content and changes in Provitamin A carotenoids during ripening of fruit from four popular Musa cultivars consumed in Eastern Democratic Republic of Congo

Poster presented at Nutrition Congress Africa 2012. Transforming the Nutrition Landscape in Africa. Bloemfontein (South Africa), 1-4 Oct 201

The extent of dietary supplements use by male rugby players in Kenya

Objective: Dietary or nutritional supplements are substances which act either nutritionally to reverse or prevent deficiency or pharmacologically, to alter some physiological processes. The purpose of the present study was to determine the extent of knowledge, consumption levels and identify factors or reasons that influenced the utilization of dietary supplements by male rugby players in Kenya. Methodology and results: The study adopted the descriptive survey design. The target population was 210 players from seven teams that participated in the Kenya Cup League. Simple random sampling was used to select 140 (67%) respondents out of the target population of 210. Percentages were used to describe the players’ knowledge levels. Generally, rugby players had moderate knowledge about the dietary supplements. This was rated at 44.9% for creatine monohydrate, antioxidants - 11.3%, multivitamins – 44.2%, glutamine – 14%, whey protein – 37.3% and Zinc Magnesium Aspartate (ZMA) -8.6%. The consumption levels (15.1% took and 53.8% never took) were low. Hypothesis testing confirmed that there was significant difference (p\u3c0.005) between the variables (age, academic qualification, occupation, experience and club affiliation) and the reasons for taking dietary supplements as well as the consumption patterns by the male rugby players Conclusion and application of findings: There were definitely low levels of use of dietary supplements among rugby players. The Kenya Rugby Football Union should organize clinics, courses and seminars for rugby coaches and teachers regarding dietary supplementation and its role in enhancing the nutritional status of the players. Further research should be conducted on the use of other dietary supplements and their effect on performance

Content and retention of provitamin A carotenoids following ripening and local processing of four popular Musa cultivars from Eastern Democratic Republic of Congo

Changes in the concentrations and retention levels of total and individual provitamin A carotenoids (pVACs) during ripening and local processing of the four most popular Musa cultivars of Eastern Democratic Republic of Congo were established through HPLC analysis. The predominant pVACs were all trans β- and α-carotene, together constituting about 90% of total pVACs content in raw and processed Musa fruit pulp. The proportion of β- and α-carotene was not significantly different in the tested East African Highland Bananas (AAA-EAHB) (‘Nshikazi’ and ‘Vulambya’); in the plantains (‘Musilongo’ and ‘Musheba’), proportion of β-carotene was almost twice that of α-carotene. An increase in total pVACs was observed during ripening, with highest levels at ripening stage 3 in all four cultivars. Total pVACs values were as high as 1081μg/100gfw in ‘Vulambya’ and 1819μg/100gfw in ‘Musilongo’. Boiling of the AAA-EAHB and AAB-Plantains resulted to retention of between 40-90% and >95% respectively. Plantains deep-fried in fully-refined palm oil and crude red palm oil for 2 minutes did not seem to lose any pVACs, the levels of total pVACs observed after frying were 100% of what was observed when the fruit was raw. Retinol Activity Equivalents (RAE), in boiled products varied between 22.3 and 173 RAEμg/100gfw, whereas deep fried products had >190 RAEμg/100g edible portion. These results show that the tested AAA-EAHBs and the plantains could meet at least 14% and 30 % of Vitamin A recommended dietary intakes respectively. The findings can therefore guide consumer consumption patterns to maximize vitamin A intake for improved health in these regions and also direct researchers in the selection of Musa cultivars to be incorporated within existing farming systems in the fight against vitamin A deficiency (VAD)

Feasibility and effectiveness of the baby friendly community initiative in rural Kenya: study protocol for a randomized controlled trial

Background: Interventions promoting optimal infant and young child nutrition could prevent a fifth of under-5 deaths in countries with high mortality. Poor infant and young child feeding practices are widely documented in Kenya, with potential detrimental effects on child growth, health and survival. Effective strategies to improve these practices are needed. This study aims to pilot implementation of the Baby Friendly Community Initiative (BFCI), a global initiative aimed at promoting optimal infant and young child feeding practices, to determine its feasibility and effectiveness with regards to infant feeding practices, nutrition and health outcomes in a rural setting in Kenya. Methods: The study, employing a cluster-randomized trial design, will be conducted in rural Kenya. A total of 12 clusters, constituting community units within the government's Community Health Strategy, will be randomized, with half allocated to the intervention and the other half to the control arm. A total of 812 pregnant women and their respective children will be recruited into the study. The mother-child pairs will be followed up until the child is 6 months old. Recruitment will last approximately 1 year from January 2015, and the study will run for 3 years, from 2014 to 2016. The intervention will involve regular counseling and support of mothers by trained community health workers and health professionals on maternal, infant and young child nutrition. Regular assessment of knowledge, attitudes and practices on maternal, infant and young child nutrition will be done, coupled with assessment of nutritional status of the mother-child pairs and morbidity for the children. Statistical methods will include analysis of covariance, multinomial logistic regression and multilevel modeling. The study is funded by the NIH and USAID through the Program for Enhanced Research (PEER) Health. Discussion: Findings from the study outlined in this protocol will inform potential feasibility and effectiveness of a community-based intervention aimed at promoting optimal breastfeeding and other infant feeding practices. The intervention, if proved feasible and effective, will inform policy and practice in Kenya and similar settings, particularly regarding implementation of the baby friendly community initiative. Trial registration:ISRCTN03467700 ; Date of Registration: 24 September 201

Effect of Peanut Consumption on Nutritional Status Indices of HIV Infected Adults in Nyeri County, Kenya

Introduction and objectives; Peanuts are a rich source of magnesium, folate, fibre, α-tocopherol, copper, arginine and resveratrol. These compounds have been shown to reduce the CVD risk in various ways. The purpose of this study was to investigate the effect of peanut supplementation on nutrition status of HIV-infected adults attending comprehensive care clinic in Nyeri Level- 5- Hospital. Methodology; The study design was a randomized cross-over trial. The eligible participants were randomly assigned to a two arm study. In treatment I, the participants consumed their regular diet supplemented with 80gms of peanuts; while in treatment II, the participants were counseled on healthy diet and supplemented it with 80gms of peanut. The participants then crossed over to respective treatments. Each treatment took 8 weeks, with a six weeks washout period between treatments. A paired T- test was used to compare subject differences in markers at baseline and at the end of each treatment. Multiple regression analysis was used to determine the effect of peanut supplementation on nutrition status. Results; Peanut supplementation significantly increased intake of total fat while carbohydrate intake decreased significantly (p < 0.05). There was no significant change in weight, BMI, waist circumference, hip circumference, body fat, body muscle, systolic and diastolic blood pressure and fasting blood glucose. There was a significant decrease (p < 0.05) in total cholesterol, triglycerides and Low density lipoprotein in both treatments while High density lipoprotein increased significantly (p < 0.05). Conclusion; Regular supplementation of a healthy diet with 80gms of peanut may improve the lipid profile without affecting the body weight status

Cardiovascular Disease Risk Factors in HIVInfected Adults in Nyeri County, Kenya

Cardiovascular diseases (CVD) is currently second, after cancer, as the most frequent cause of death among HIV-positive subjects in areas of the world where Highly active anti-retroviral therapy (HAART) is widely available. The purpose of this study was to investigate cardiovascular disease markers in HIV-infected adults attending comprehensive care clinic in Nyeri Level- 5- Hospital. The results are based on a sample of 85 participants that randomly selected for an intervention study with two study arms. Descriptive statistics were used to analyze all study variables. Relationships between all and individual CVD risk factors were analyzed using Spearman’s correlation coefficient. Criterion for statistical significance was at p < 0.05 and 90% power of test. Twenty nine percent of the respondents were aged fifty years and above while 48.2% were between 40-49 years. Only 5.9% of the respondents smoked while 8.2% drunk alcohol. Twenty seven percent (27.1%) had low physical activity while 24.7% had obesity class I (30-34.9), 8.2% had obesity class II (35-39.9) while 1.5% had obesity class III (> 40). Another 31.8% were overweight (25-29.9). 28.2% had hypertension stage I (140-159) and another 11.8% had hypertension stage II (>160). Twenty two percent (22.4%) had high total cholesterol (>6.2), while 34.1% had high serum triglycerides (2.25-5.6) and another 4.7% had very high serum LDL-C (>4.91). Framingham’s risk score was used to determine the 10-year risk of developing a coronary heart disease. Majority of the participants (60%) had low (<10%) 10-year risk of coronary heart disease at the baseline. There is a high prevalence of hypertension and overweight/obesity among HIV+ patients