Fermented sorghum porridge fortified with Moringa leaf powder and baobab fruit pulp cured children from moderate acute malnutrition in Benin

Inappropriate feeding, too early introduction of complementary foods and restriction in food selection are a major cause of malnutrition among young children in developing countries. Food-to-food fortification is a good strategy to enhance the nutritional quality of children’s diet. This strategy is more and more promoted because it allows delivery of micronutrients to a large population in a cost-effective manner. The present study aimed at testing the effect of the consumption of sorghum porridge fortified with moringa leaf powder and baobab fruit pulp on the nutritional status of children aged 6 to 59 months in Northern Benin. A two-week intervention was implemented in Tanguiéta (Benin) among children affected by moderate acute malnutrition, using 400 g of fermented sorghumporridge fortified with 15 g of a designed mix of moringa leaf powder and baobab fruit pulp. Sixty-three children aged 6–59 months who had malnutrition assessed by anthropometry were randomly selected and assigned to a treatment or a control group. Children in the treatment group consumed the fortified formula daily for two weeks in a nutritional rehabilitation hearth whereas those in the control group had their habitual diet. Their nutritional status was evaluated using anthropometry. Recovery rate and average weight gain of children were computed. Results show that daily consumption of the fortified food for two weeks did not significantly (P> 0.05) increase children’s weight in treatment vs. control. However, average weight gain was 9.85 g/kg/day in the treatment group and total recovery rate at risk of malnutrition and moderate acute malnutrition was 62.50% among children who fully complied with the  intervention. Fermented sorghum porridge fortified with moringa leaf powder and baobab fruit pulp may be promoted to scale in more regions of Benin as a local affordable and effective therapeutic food against child acute malnutrition. Further investigation of its  potential effect while accounting for parasitic infection is needed, to eliminate all risks of intestinal micronutrient  malabsorption or malaria and enhance the effectiveness of the fortified food on children’s weight as well as their iron status. Key words: Food-to-food fortification, malnutrition, sorghum porridge, northern Beni

A Conceptual Framework for Healthy Eating Behavior in Ecuadorian Adolescents: A Qualitative Study

Objective: The objective of this study was to identify factors influencing eating behavior of Ecuadorian adolescents - from the perspective of parents, school staff and adolescents - to develop a conceptual framework for adolescents’ eating behavior. Study design: Twenty focus groups (N = 144 participants) were conducted separately with adolescents aged 11–15 y (n (focus groups) = 12, N (participants) = 80), parents (n = 4, N = 32) and school staff (n = 4, N = 32) in rural and urban Ecuador. A semi-structured questioning route was developed based on the ‘Attitude, Social influences and Self-efficacy’ model and the socio-ecological model to assess the relevance of behavioral and environmental factors in low- and middle-income countries. Two researchers independently analyzed verbatim transcripts for emerging themes, using deductive thematic content analysis. Data were analyzed using NVivo 8. Results: All groups recognized the importance of eating healthily and key individual factors in Ecuadorian adolescents’ food choices were: financial autonomy, food safety perceptions, lack of self-control, habit strength, taste preferences and perceived peer norms. Environmental factors included the poor nutritional quality of food and its easy access at school. In their home and family environment, time and convenience completed the picture as barriers to eating healthily. Participants acknowledged the impact of the changing socio-cultural environment on adolescents’ eating patterns. Availability of healthy food at home and financial constraints differed between settings and socio-economic groups. Conclusion: Our findings endorse the importance of investigating behavioral and environmental factors that influence and mediate healthy dietary behavior prior to intervention development. Several culture-specific factors emerged that were incorporated into a conceptual framework for developing health promotion interventions in Ecuador

Low Lipoprotein(a) Concentration Is Associated with Cancer and All-Cause Deaths: A Population-Based Cohort Study (The JMS Cohort Study)

Background: Experimental studies support the anti-neoplastic effect of apo(a), but several clinical studies have reported contradictory results. The purpose of this study was to determine whether a low lipoprotein(a) [Lp(a)] concentration is related to mortality from major causes of death, especially cancer. Methods The subjects were 10,413 participants (4,005 men and 6,408 women) from a multi-center population-based cohort study in Japan (The Jichi Medical School cohort study). The average age at registration was 55.0 years, and the median observation period was 4,559 days. As the estimated hazard ratio was high for both the low and very high Lp(a) levels, we defined two Lp(a) groups: a low Lp(a) group [Lp(a)<80 mg/L] and an intermediate-to-high Lp(a) group [Lp(a)≥80]. Participants who died from malignant neoplasms (n = 316), cardiovascular disease (202), or other causes (312) during the observation period were examined. Results: Cumulative incidence plots showed higher cumulative death rates for the low Lp(a) group than for the intermediate-to-high Lp(a) group for all-cause, cancer, and miscellaneous-cause deaths (p<0.001, p = 0.03, and p = 0.03, respectively). Cox proportional hazards analyses with the sex and age of the participants, body mass index, and smoking and drinking histories as covariates showed that a low Lp(a) level was a significant risk for all-cause, cancer, and miscellaneous-cause deaths (p<0.001, p = 0.003, and p = 0.01, respectively). The hazard ratio (95% CI) [1.48, 1.15–1.92] of a low Lp(a) level for cancer deaths was almost the same as that for a male sex (1.46, 1.00–2.13). Conclusions: This is the first report to describe the association between a low Lp(a) level and all-cause or cancer death, supporting the anti-neoplastic effect of Lp(a). Further epidemiological studies are needed to confirm the present results

The bii4africa dataset of faunal and floral population intactness estimates across Africa’s major land uses

Sub-Saharan Africa is under-represented in global biodiversity datasets, particularly regarding the impact of land use on species’ population abundances. Drawing on recent advances in expert elicitation to ensure data consistency, 200 experts were convened using a modified-Delphi process to estimate ‘intactness scores’: the remaining proportion of an ‘intact’ reference population of a species group in a particular land use, on a scale from 0 (no remaining individuals) to 1 (same abundance as the reference) and, in rare cases, to 2 (populations that thrive in human-modified landscapes). The resulting bii4africa dataset contains intactness scores representing terrestrial vertebrates (tetrapods: ±5,400 amphibians, reptiles, birds, mammals) and vascular plants (±45,000 forbs, graminoids, trees, shrubs) in sub-Saharan Africa across the region’s major land uses (urban, cropland, rangeland, plantation, protected, etc.) and intensities (e.g., large-scale vs smallholder cropland). This dataset was co-produced as part of the Biodiversity Intactness Index for Africa Project. Additional uses include assessing ecosystem condition; rectifying geographic/ taxonomic biases in global biodiversity indicators and maps; and informing the Red List of Ecosystems

Food safety Is a key determinant of fruit and vegetable consumption in urban Beninese adolescents

OBJECTIVE: To identify the determinants of fruit and vegetable consumption in urban Beninese adolescents and elements to develop a school-based fruit and vegetable program. DESIGN: Sixteen focus groups conducted with a key word guide. SETTING AND PARTICIPANTS: Two private and 2 public secondary schools in Cotonou, Benin. One hundred fifty-three students aged 13 to 19 years, 54% girls. ANALYSIS: The focus groups were audiotaped, transcribed, and analyzed. Three a priori categories from the Social Cognitive Theory were used for the coding: socioenvironmental, personal, and behavioral factors. Additionally, the data were checked to determine whether new categories should be created. RESULTS: Major determinants in the school were availability and accessibility of fruits and vegetables, nutrition education, and the competition of unhealthful foods. Food safety emerged as a strong barrier to the adolescents' fruit and vegetable consumption outside home and particularly at school. CONCLUSIONS AND IMPLICATIONS: Except for food safety, the determinants of fruit and vegetable intake in Beninese adolescents were similar to those in high-income countries. The food safety of fruits and vegetables outside home is a key issue to be studied in detail and integrated in any intervention in Benin and potentially other low- and middle-income countries

Food, energy and macronutrient contribution of out-of-home foods in school-going adolescents in Cotonou, Benin

The objective of the present study was to document the food, energy and macronutrient contribution of out-of-home prepared foods in school-going adolescents in Cotonou (Benin) and compare the food, energy and macronutrient intakes of low and high out-of-home consumers. We used a cross-sectional study with 24 h dietary recalls on two non-consecutive school days to collect food intake data. Low and high consumers were defined respectively as subjects whose percentage of daily energy intake from out-of-home foods was in the first and the third terciles of the sample distribution. The setting was twelve secondary schools in Cotonou with 656 adolescents aged 13-19 years. Out-of-home prepared foods contributed more than 40 % of the daily energy, fat, protein, carbohydrate and fibre intakes and of the daily weight of food in the adolescents. They were highly present at breakfast and as afternoon snacks in high consumers, providing respectively 94 and 82 % of the energy intake of high consumers at breakfast and as afternoon snacks. Low consumers ate more fruit and vegetables and cereal grain products than high consumers whereas high consumers consumed more sweet energy-dense foods. Both categories had a diet poor in fruit and vegetables (hardly one-fourth of the recommended 400 g) and high in fat. We concluded that out-of-home foods are important in the diet of urban school adolescents in Benin. Therefore, they should be investigated in depth and taken into account in the development of interventions to promote healthy diet and lifestyles in adolescents

Yam chip food subsector: hazardous practices and presence of aflatoxins in Benin

A survey of the sanitary quality, particularly concerning aflatoxin contamination and practices of the dried yam chips food sub-sector was carried out in Benin. Producers and intermediaries of the yam chips food production sub-sector were interviewed and samples collected. Aflatoxin content was assessed by a biochemo-luminescence method on a total of 107 samples. Twenty-three per cent of the samples had aflatoxin contents over the 15 μg kg−1 CODEX standard value for total aflatoxin. Moisture content of whole tuber chips was around 20% when producers stopped drying after 3–6 days. Drying was thus not accomplished, but most producers were unaware of this problem. After storage for 7 months, mean moisture content was around 14%, but 41% of the samples stored in rooms had a moisture content over 15%, levels that are still favourable for mould growth. Most producers, wholesalers and retailers complained about storage problems and particularly about insect proliferation, but less than 15% mentioned mould growth as a problem. Mouldy chips are generally washed and dried again. Very rarely are mouldy chips discarded and lack of moulds is not a quality attribute for dried yam chips. Therefore, there is a risk of chronic exposure to aflatoxin for Beninese yam chips consumers