Effect of locally produced complementary foods on fat-free mass, linear growth, and iron status among Kenyan infants: A randomized controlled trial.

The impact of quality complementary food products on infant growth and body composition has not been adequately investigated. This study evaluated the effect on fat-free mass (FFM) accrual, linear growth, and iron status of locally produced complementary food products comparing to a standard product. In a randomized, double-blind trial, 499 infants at 6 months received nine monthly rations of (a) WinFood Classic (WFC) comprising germinated amaranth (71%), maize (10.4%), small fish (3%), and edible termites (10%); (b) WinFood Lite (WFL) comprising germinated amaranth (82.5%), maize (10.2%), and multimicronutrient premix; or (c) fortified corn-soy blend plus (CSB+). Primary outcomes were changes in FFM, length, and plasma ferritin and transferrin receptors (TfR). FFM was determined using deuterium dilution. Analysis was by intention to treat, based on available cases. Compared with CSB+, there were no differences in change from 6 to 15 months in FFM for WFC 0.0 kg (95% CI [-0.30, 0.29]) and WFL 0.03 kg (95% CI [-0.25, 0.32]) and length change for WFC -0.3 cm (95% CI [-0.9, 0.4]) and WFL -0.3 cm (95% CI [-0.9, 0.3]). TfR increased in WFC group 3.3 mg L-1 (95% CI [1.7, 4.9]) and WFL group 1.7 mg L-1 (95% CI [0.1, 3.4]) compared with CSB+. Compared with the increase in Hb in CSB+ group, there was a reduction in Hb in WFC of -0.9 g dl-1 (95% CI [-1.3, -0.5]) and a lower increase in WFL -0.4 g dl-1 (95% CI [-0.8, 0.0]). In conclusion, the tested WinFoods had the same effect on FFM and length as CSB+, whereas Hb and iron status decreased, suggesting inhibited iron bioavailability from the amaranth-based WinFoods

A cross-sectional study of associations between the 13C-sucrose breath test, the lactulose rhamnose assay, and growth in children at high risk of environmental enteropathy

Background: Environmental enteropathy’ (EE) is common among children who are highly exposed to enteric pathogens in low-resource settings. We optimised and validated a stable isotope-based breath test of intestinal sucrase activity (13C-SBT) as a non-invasive test of carbohydrate digestion and metabolism. Objectives: The primary objective of this study was to assess the relationship between the 13C-SBT and the lactulose/rhamnose ratio (LR) and growth in children. Secondary objectives were to assess the relationship between the 13C-SBT and additional biomarkers of EE. We also characterised the relationship between the 13C-SBT and child sex anddietary diversity, and household socioeconomic status and food security. Methods: In this cross-sectional study, 12-to-15-month-old children were recruited in Bangladesh, India, Kenya, and Peru. Children were assessed with a 4-hour 13C-SBT and a 90-minute LR test. Plasma was collected for the determination of citrulline and the kynurenine/tryptophan ratio. Length and weight were measured, and other variables were assessed through questionnaires. For a subset of children, anthropometry was re-measured after three months. inear regression was used to examine associations corresponding to each objective. Results: Three sites generated 13C-SBT breath curves that enabled pooled analysis. Differences in 13C-SBT breath curves, LR ratios, and other EE biomarkers were observed between sites. No associations were observed for 13C-SBT summary measures and LR, or child growth (e.g., association between LR and cumulative percent dose recovered at 90 minutes (cPDR90): -0.39, 95%CI: -1.79, 0.70). Length-for-age and weight-for-age were positively associated with the time to 50% of dose recovered (T50) (0.05, 95%CI: 0.01, 0.09, and 0.05, 95%CI: 0.02, 0.07, respectively), and dietary diversity was associated with T50 and cPDR90(-0.10, 95%CI: -0.18, -0.02 and 2.67, 95%CI: 0.47, 4.88, respectively). Conclusions: In children at risk of EE there were no associations between the 13C-SBT, LR or other EE biomarkers encompassing different pathophysiological domains of EE

Linkage between nutritional status of children 6-59 months and some socio-demographic and economic characteristics of mothers in Malava sub-county, Kakamega county

The world is currently battling the triple burden of malnutrition across all age groups including children. In Kenya, household socio-demographic and economic characteristics have been shown to contribute to malnutrition among children, but there is little known about the magnitude of their contribution at the sub-county level. This study aimed at determining the association between socio-demographic and economic characteristics of mothers and the nutritional status of their children 6-59 months old. This was a cross-sectional study conducted in November and December of 2021 in Malava Sub-county, Kakamega County, Kenya. Data were collected from households using semi-structured questionnaires administered to 344 randomly selected mothers who had children aged 6-59 months. Nutritional status was determined using anthropometric measurements translated to nutrition indicators using WHO Anthro software. Association between the study variables was determined using Chi-square test. About 53% of the mothers were aged < 25 years. Formal education of mothers was low with 14.5% having no education at all and 46.8% having completed primary level only. Poverty rate was high in the study area with 83.7% of the mothers being unemployed and 77.9% earning less than Ksh. 5,000 (50 USD) per month. Only 14.5% engaged in business as an economic activity. Malnutrition prevalence in Malava Sub-county was high with almost 21% of the children being stunted and 8.1% being severely stunted. The prevalence of wasting and underweight were at 12.5% and 7.5%, respectively. Significant associations were observed between the stunting and the age of the mother (p=0.036) and education level (p=0.023). Education was also significantly associated with wasting (p=0.008). Underweight was associated with education level (p=0.014), average household monthly income (p=0.019) and the household economic activity engagement (p=0.01). The study recommends a multi-sectoral collaboration in addressing the household demographic and economic characteristics that may help in reducing the prevalence of malnutrition in Malava Sub-county, Kakamega County

Relationship between household characteristics and food security among households with school going children 6-14 years in Turkana county, Kenya

Good nutrition is very essential for proper growth and development of school going children. Malnutrition among school-going children affects their physical and cognitive development leading to low-class attendance hence poor school performance. Despite the economic growth observed in developing countries in recent years, undernutrition is still predominant. This study aims to determine the household food and nutrition security among households with school going children 6-14 years in Turkana County. A cross-sectional study design was adopted where 386 children were sampled for study. Turkana West Sub- County was purposively selected and the wards, locations sub-locations and villages were randomly selected. Systematic random sampling was used to sample households with school going children 6-14 years. A structured questionnaire survey was conducted on parents/guardians. Statistical analysis was performed using Statistical Package for Social Sciences Software (SPSS) Version 25. Data was analyzed using descriptive and multivariate statistics at 95% confidence interval. About 60% (n=228) of the households were headed by males with 62.2% aged between 20-30years. The large proportion of the respondents (58.8%) had attained primary education level only. Charcoal and firewood selling (25.6%) was the main occupation of the household heads, 13.2 % provided agricultural labor and only 2.1% had a formal employment. The rest did not have any source of income. The average dietary diversity score of the individuals was 5 to7 food groups while the highest dietary diversity score was 8-10 food groups. The school going children (6-14 years) had a medium dietary score with 45.9% while 22.3% had a low dietary diversity score. The study indicated that there was a significant relationship between dietary diversity and the nutrition security of the school going children 6-14 years. Findings of this study are useful in informing the County government of Turkana in the planning and implementation of relevant food and nutrition security programs in the Turkana West community. The study recommends adequate nutrition support to be incorporated in the school feeding program in the locality

Nutritional knowledge and practice of elite rugby players in Kenya

Rugby is a sport that has great physical and physiological demands that come with heavy requirements on the body’s nutrient stores. Nutrition plays a key role when it comes to good performance in rugby and in turn, aspects of nutrition specifically relevant to rugby are used to improve on how an athlete performs throughout the year: pre-season, competition season and off season. Despite the tremendous growth of rugby within the global and Kenyan scene, there are few studies that have been done on the nutrition knowledge and practices of elite rugby union players. The general objective of this study was to investigate the nutritional knowledge and practices of elite rugby players in Kenya. This study adopted the descriptive cross-sectional design. The research was carried out in Nairobi and Kakamega counties in Kenya. Purposive sampling was used to select elite rugby players called up to the national team and the sample size for this study was sixty-seven (67). The data was analysed using SPSS version 25. The study’s results showed that 46% of the respondents were found to be in the age bracket of 25-30 years, with 52% of the respondents having attained tertiary education. Sixty percent (60%) of the respondents played the back position. A large proportion (75%) of the respondents correctly responded that carbohydrates were the main source of energy for the body, whereas only 23% correctly responded that sports drinks are the best to replace fluids on the field of play. The average daily kilocalorie intake of the respondents was low at 2097kcal against a recommended 2165kcal. Milk and milk products were the most consumed sources of protein at 37% (5-6 times a week). Cereals were the most common sources of energy at 30% (daily). There was no significant relationship between nutrition practice and nutrition knowledge amongst elite rugby players in Kenya (r (67) = -0.106, p = .400.). In conclusion, good nutrition knowledge did not necessarily translate to better nutrition practices. There is need for increased nutrition education amongst elite rugby players to ensure dietary intake is per set recommendations

Associations between Stunting, Wasting, and Body Composition: A Longitudinal Study in 6- to 15-Month-Old Kenyan Children

BACKGROUND: Early growth and body composition may influence the risk of obesity and health in adulthood. Few studies have examined how undernutrition is associated with body composition in early life. OBJECTIVES: We assessed stunting and wasting as correlates of body composition in young Kenyan children. METHODS: We performed a nested, randomized, controlled nutrition trial that assessed FM and FFM using the deuterium dilution technique among children aged 6 and 15 mo. This trial was registered at http://controlled-trials.com/ (ISRCTN30012997). Cross-sectional and longitudinal associations between z-score categories of length-for-age (LAZ) or weight-for-length (WLZ) and FM, FFM, fat mass index (FMI), fat-free mass index (FFMI), triceps, and subscapular skinfolds were analyzed by linear mixed models. RESULTS: Among the 499 children enrolled, breastfeeding declined from 99% to 87%, stunting increased from 13% to 32%, and wasting remained at 2% to 3% between 6 and 15 mo. Compared with LAZ >0, stunted children had a 1.12 kg (95% CI: 0.88, 1.36; P 0.40). Stunting was associated with 0.28 kg (95% CI: 0.09, 0.47; P = 0.004) lower FM at 6 mo. However, this association was not significant at 15 mo, and stunting was not associated with FMI at any time point. A lower WLZ was generally associated with lower FM, FFM, FMI, and FFMI at 6 and 15 mo. Differences in FFM, but not FM, increased with time, whereas FFMI differences did not change, and FMI differences generally decreased with time. CONCLUSIONS: Overall, low LAZ and WLZ among young Kenyan children were associated with reduced lean tissue, which may have long-term health consequences

Associations between Stunting, Wasting and Body Composition: A Longitudinal Study in 6- to 15-Month-Old Kenyan Children

BACKGROUND: Early growth and body composition may influence the risk of obesity and health in adulthood. Few studies have examined how undernutrition is associated with body composition in early life. OBJECTIVES: We assessed stunting and wasting as correlates of body composition in young Kenyan children. METHODS: Nested in a randomized controlled nutrition trial, this longitudinal study assessed fat and fat-free mass (FM, FFM) using deuterium dilution technique among children at age 6 and 15 months. This trial was registered at http://controlled-trials.com/ (ISRCTN30012997). Cross-sectional and longitudinal associations between z-score categories of length-for-age (LAZ) or weight-for-length (WLZ) and FM, FFM, fat mass index (FMI), fat-free mass index (FFMI), triceps, and subscapular skinfolds were analyzed by linear mixed models. RESULTS: Among the 499 children enrolled, breastfeeding declined from 99% to 87%, stunting increased from 13% to 32%, and wasting remained at 2% to 3% between 6 and 15 mo. Compared with LAZ >0, stunted children had a 1.12 kg (95% CI: 0.88, 1.36; P 0.40). Stunting was associated with 0.28 kg (95% CI: 0.09, 0.47; P = 0.004) lower FM at 6 mo. However, this association was not significant at 15 mo, and stunting was not associated with FMI at any time point. A lower WLZ was generally associated with lower FM, FFM, FMI, and FFMI at 6 and 15 mo. Differences in FFM, but not FM, increased with time, whereas FFMI differences did not change, and FMI differences generally decreased with time. CONCLUSIONS: Overall, low LAZ and WLZ among young Kenyan children were associated with reduced lean tissue, which may have long-term health consequences