Consumption of dairy, fruits and dark green leafy vegetables is associated with lower risk of adverse pregnancy outcomes (APO): a prospective cohort study in rural Ethiopia

Background: Poor maternal nutrition during pregnancy is a leading modifiable risk factor associated with risks of adverse pregnancy outcomes (APO). Nevertheless, there is paucity of evidence if consumption of some food groups is associated with lower risk of APO, particularly in low-income settings. We aimed to determine whether consumption of some food groups is associated with lower risk of APOs such as: preterm birth (PTB), low-birth weight (LBW), and stillbirth in rural Central Ethiopia. Methods: A multi-center (8 health centers) prospective cohort study, enrolling 432 pregnant women during their initial antenatal care visit, was employed. All mothers were then followed monthly (for a total of four visits) from enrollment to delivery. Midwives in respective health centers assessed dietary diversity using the Women’s individual dietary diversity score and evaluated birth outcomes following standard procedures. Logistic regression models were run to predict association of food groups with the APO. Findings: Out of the 374 pregnant women who completed the study, one in five [74 (19.8%)] experienced at least one of the APO: 34 (9.1%) gave birth to LBW babies, 51(13.6%) had PTB and 17 (4.5%) experienced stillbirth. Poor or inconsistent consumption (<¾ assessments) of dark green leafy vegetables (adjusted odds ratio (AOR) = 2.01; 95% confidence interval (CI): 1.04–3.87), dairy products (AOR = 2.64; 95% CI: 1.11–6.30), and fruits and vegetables (AOR = 2.92; 95% CI: 1.49–5.67) were independently associated with higher APO risks. Whereas, being nonanemic at term (AOR = 0.24; 95% CI: 0.12–0.48) was independently associated with lower APO risks. Conclusions: Poor or inconsistent consumption of dairy, dark green leafy vegetables and fruits were associated with higher risk of APOs. While community-based trials and mechanistic studies are needed to substantiate these findings, efforts to promote dietaryinfo:eu-repo/semantics/publishedVersio

Quantification of folate in the main steps of traditional processing of tef injera, a cereal based fermented staple food

Injera is an Ethiopian fermented flatbread preferably made from whole grain cereal (tef). Tef it is increasingly used to produce gluten-free pasta and bread, but the folate content of teff and products made from it remains unknown. Given that folate deficiencies lead to several health disorders, the aim of this study was to quantify folate in each of the three main steps of traditional processing of tef injera. Total folate contents of tef flour, fermented batter and injera were determined through microbiological assays using Lactobacillus rhamnosus (ATCC 7469). Folate content of tef flour was 8.7 mu g/100 g of dry matter content, which is in the same range as the richest cereals like oats. The increase in folate content due to fermentation was highly variable (60-148%). Cooking always led to folate losses, with a maximum of 52.8%. Altogether, injera processing increased folate retention between 38.0 and 121.8%. Folate content of injera was 14.3 mu g/100 g on fresh weight-basis. Tef injera can contribute up to 10% of the recommended nutrient intake of folate for children aged 1-3 and women of reproductive age. Although the folate content of teff is already high, future studies should focus on optimizing the folate content of injera.Peer reviewe

Seasonal Food Availability Calendar in Basona, Sinana and Lemo Woredas of Amhara, Oromia and SNNP Regions of Ethiopia

Seasonality is one of the key factors in determining food availability, especially of perishable foods like fruits and vegetables. Having multiple seasonal food-availability data provides a better understanding of the type of foods available in a given area/region. Therefore, a second round of seasonal food-availability assessments was conducted using participatory action research in three Africa RISING intervention areas to support its nutrition objectives. Data was collected in October 2021 through Focus Group Discussions (FGDs) and Key Informant Interviews (KIIs). The same enumerators were used for the first and second round survey, except for Lemo district. A second training/refresher was given to the enumerators to ensure full and common understanding of the tools (they were trained during the first-round survey). The same participants who were involved in the first-round survey were interviewed – these included experienced farmers and merchants familiar with seasonal dynamics of foods and involved a balance of men and women with a balanced mix of ages, diverse ethnicity, and economic status. A total of 75 participants were involved through 12 FGDs and 8 KIIs in the study. Participants were asked to list all the food items available for consumption in the community and to specify the months that each food item is available. Each food item was categorized into a food group based on Mean Dietary Diversity -Women methodology guidebooks like: Grains, white roots and tubers = 1; Pulses = 2; Nuts and seeds =3; Meat, Poultry and Fish = 4; Eggs = 5; Dark green leafy vegetables (DGLV) =6; Other Vitamin A-rich fruit and =7; Other vegetables= 8; Other fruits =9; and Milk and other dairy products = 10. The levels of availabilities each month and each food item were scored on a scale of 0 to 3 in which 0 represents – no availability; 1 represents low availability; 2 represents moderate availability and 3 for high availability. The average of the availability score across all the focus groups was taken to integrate the dataset and average availability of each species was calculated for each month. A color scale was applied using conditional formatting in Excel. The results have been organized into three sections based on geographical area including information about diversity, culinary use, source of species, and seasonal availability of the different food species. The overall availability of foods in the area in each month was summarized by food groups. For example, in Basona Woreda in Amhara Region, N/Shewa Zone, the availability of cereals was high to moderate from December to April. However, availability of nuts was low the entire year. Moderate availability of meat, poultry and fish was documented from December to February. Dark green leafy vegetables were moderately available from July to December. Whereas other vitamin A-rich fruits and vegetables were low through the year. For most of the year, there was no availability of species of “other fruits”. Milk and other dairy products were only available for four months a year. In Sinana woreda, Oromia region, cereals and pulses were available from high to moderate levels for eight months a year. However, nuts were only available for three months a year and no availability for the rest of the year. Meat, poultry and fish, eggs, other vitamin A-rich fruits and vegetables and other fruits were low for most of the year. Other vegetables and milk and other dairy products were moderately available from July to January. In Lemo woreda, dark green leafy vegetables ranked top for highly available foods from all food groups, eight months a year, followed by other fruits and other vitamin A-rich fruits and vegetables. Eggs were low the entire year. Based on the information gathered, a seasonal food availability calendar was developed using a color gradient to represent the availability of food species. The finding of this research supported the idea that conducting a second round of seasonal food availability assessments enables a better knowledge of the kinds of foods that are readily available in the locally. Overall, compared to other food groups, cereals’ diversity and availability were slightly better in all districts. Very limited number of food items were identified under DGLVs in all districts. Other V-A rich vegetables and fruits were entirely low in diversity and availability in Basona and Sinana districts and relatively better in Lemo district. For most of the year, there was little perceived availability of nuts, meat, poultry and fish. This result implies a significant gap in the intake of fruits, vegetables, and animal products which calls for more intervention on nutrient dense food production that would broaden diet options and substantially enhance the nutrition status. To strengthen food security through diet diversification especially concerning the lean periods, nutrition interventions should be put in place.

Dietary habits, food taboos, and perceptions towards weight gain during pregnancy in Arsi, rural central Ethiopia: a qualitative cross-sectional study

Background: The nutritional status of women before and during pregnancy can be determined by maternal knowledge, attitudes, and perceptions towards certain foods. The present study aimed to explore maternal dietary habits, food taboos, and cultural beliefs that can affect nutrition during pregnancy in rural Arsi, central Ethiopia. Methods: A qualitative, cross-sectional study, involving 38 key informant in-depth interviews and eight focus group discussions, was conducted among purposefully selected pregnant women and their husbands, elderly people, community leaders, health workers, and agriculture office experts. Participants were selected purposefully from all the major agro-ecologic areas of the study site. Data was analyzed manually using the thematic framework analyses method. Results: The pregnant women reported that they did not change the amount and type of foods consumed to take into account their increased nutritional need during pregnancy. The consumption of meat, fish, fruits, and some vegetables during pregnancy remained as low as the pre-pregnancy state, irrespective of the women\u2019s income and educational status. Although not practiced by all, a number of taboos related to the intake of certain food items and misconceptions that can adversely affect nutritional status during pregnancy were identified. The most common taboos were related to the consumption of green leafy vegetables, yogurt, cheese, sugar cane, and green pepper. However, the frequency and extent of the practice varied by maternal age, family composition, and literacy level. Older mothers, from rural villages, and those with no formal education were more likely to practice the taboos than younger and educated ones. Almost all of the participants disfavored weight gain during pregnancy in fear of obstetric complications associated with the delivery of a bigger infant. Conclusions: Misconceptions about weight gain during pregnancy and food taboos were widespread, particularly among older and illiterate rural communities. Thus, future nutrition programs should promote diversification of both the agricultural production and consumption

Lactobacillus plantarum P2R3FA Isolated from Traditional Cereal-Based Fermented Food Increase Folate Status in Deficient Rats

Folate deficiencies are widespread around the world. Promoting consumption of folate-rich foods could be a sustainable option to alleviate this problem. However, these foods are not always available. Cereals, being a staple food, could contribute to folate intake. They are fermented prior to consumption in many African countries, and fermentation can modify the folate content. In Ethiopia, injera is a widely consumed fermented flat bread. The main drivers of its fermentation are lactic acid bacteria (LAB). The aim of this work was to isolate and identify folate-producing LAB from injera fermented dough and to evaluate their ability to increase folate status after depletion in a rat model. Among the 162 strains isolated from 60 different fermentations, 19 were able to grow on a folate-free culture medium and produced 1 to 43 µg/L (24 h, 30 °C incubation). The four highest folate producers belonged to the Lactobacillus plantarum species. The most productive strain was able to enhance folate status after depletion in a rat model, despite the relatively low folate content of the feed supplemented with the strain. Folate-producing L. plantarum strain has potential use as a commercial starter in injera production

Lactobacillus plantarum P2R3FA Isolated from Traditional Cereal-Based Fermented Food Increase Folate Status in Deficient Rats

Folate deficiencies are widespread around the world. Promoting consumption of folate-rich foods could be a sustainable option to alleviate this problem. However, these foods are not always available. Cereals, being a staple food, could contribute to folate intake. They are fermented prior to consumption in many African countries, and fermentation can modify the folate content. In Ethiopia, injera is a widely consumed fermented flat bread. The main drivers of its fermentation are lactic acid bacteria (LAB). The aim of this work was to isolate and identify folate-producing LAB from injera fermented dough and to evaluate their ability to increase folate status after depletion in a rat model. Among the 162 strains isolated from 60 different fermentations, 19 were able to grow on a folate-free culture medium and produced 1 to 43 µg/L (24 h, 30 °C incubation). The four highest folate producers belonged to the Lactobacillus plantarum species. The most productive strain was able to enhance folate status after depletion in a rat model, despite the relatively low folate content of the feed supplemented with the strain. Folate-producing L. plantarum strain has potential use as a commercial starter in injera production

The role of water in transforming food systems

The United Nations Food Systems Summit aimed to chart a path toward transforming food systems toward achieving the Sustainable Development Goals. Despite the essentiality of water for food systems, however, the Summit has not sufficiently considered the role of water for food systems transformation. This focus is even more important due to rapidly worsening climate change and its pervasive impacts on food systems that are mediated through water. To avoid that water "breaks" food systems, key food systems actors should 1) Strengthen efforts to retain water-dependent ecosystems, their functions and services; 2) Improve agricultural water management; 3) Reduce water and food losses beyond the farmgate; 4) Coordinate water with nutrition and health interventions; 5) Increase the environmental sustainability of food systems; 6) Explicitly address social inequities; and 7) Improve data quality and monitoring for water-food system linkages