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

Maternal Perception on Use of Edible Insects for Complementary Feeding and Nutritional Status of Children in Kakamega and Siaya Counties, Kenya

Despite the high protein levels, essential fatty acids and minerals that are found in edible insects, they are still not being used in complementary feeding. The aim of this study was to investigate maternal perception on use of edible insects for complementary feeding and nutrition status of children in Kakamega and Siaya Counties, Kenya. The study adopted a cross-sectional analytical design which was used on a sample of 592 mother-child pairs (aged 6-23 months) in Kisa North, West Yimbo and West Ugenya wards. Majority of the mothers were in the childbearing age group of 15-49 years, were married and 57.9% in Kisa North, 65.7% in West Ugenya and 64.6% in West Yimbo had attained primary education. Generally, 50.9%, 54.2% and 48.8% of the household heads in Kisa North, West Ugenya and West Yimbo, respectively had attained primary education. About 49.5% and 38.9% of the mothers in Kisa North and West Ugenya practiced farming while 35.3% of those in West Yimbo engaged in business. About 40.3% of the household heads in West Ugenya were farmers, 48.7% in Kisa North were casual labourers while 66.3% in West Yimbo engaged in fishing. Approximately 42.1%, 33.7% and 39.3% of the mothers in Kisa North, West Ugenya and West Yimbo respectively disagreed about the use of edible insects for complementary feeding. More than half (65.3%, 56.6% and 61.7%) of the children in Kisa North, West Ugenya and West Yimbo respectively attained the Minimum Dietary Diversity. More than half (58.9% and 55.8%) of the children in West Yimbo and West Ugenya respectively and 29.7% in Kisa North attained the Minimum Acceptable Diet. In terms of nutrition status, the prevalence rates of wasting were (6.3% in West Ugenya, 7.0% in West Yimbo and 6.0% in Kisa North), stunting rates (19.5% in West Ugenya and an equal proportion of 19.9% in West Yimbo and Kisa North) and underweight rates (9.2% in West Ugenya, 9.0% in West Yimbo and 8.8% in Kisa North). There were significant relationships between the maternal perceptions of the appropriateness of insects in complementary food and the ward of residence (ꭓ²=16.86, p value=0.030), marital status of the mother (ꭓ²=11.14, p value=0.025), main source of income for the household head (ꭓ²=33.35, p value=0.007) and the education level of the household head (ꭓ²=48.67, p value=0.009). This information will be useful to the Ministry of Health through the division of nutrition for inclusion in the MIYCN policy the use of edible insects as a complementary food