The impact of different dietary patterns on nutritional status and metabolic integrity in asymptomatic people living with HIV infection in South Africa

Adequate nutritional status promotes optimal structure and function. In PLWH, few studies on the impact of dietary intake on nutritional and metabolic status have been undertaken. This cross-sectional secondary data analysis examined how different dietary patterns influenced nutritional and metabolic integrity in asymptomatic PLWH in the North-West Province of South Africa. Dietary data were collected using validated QFFQ. Data analysis was by SPSS version 14. Dietary and nutrient patterns were generated using Principal Component Analysis. Though asymptomatic, marked biochemical differences depicting altered metabolism and inflammation were observed in PLWH compared to the uninfected. PLWH also showed an anthropometric profile that depicted altered body composition and abnormal fat distribution. Four dietary patterns: animal-based, ‘recommended’, staple, and the Carbohydrate, Vegetable and Legumes (CVL) based were observed in both PLWH and the uninfected with slight differences. In PLWH, the animal-based similar to the CVL pattern was associated with better overall nutrient intake (r=0.5, p<0.001) and selected nutrients, including energy (r=0.3, p<0.001), protein (r=0.6, p<0.001), iron (r=0.5, p<0.001), zinc (r=0.6, p<0.001) and vitamin A (r=0.5, p<0.001), compared to the other dietary patterns. The animal based dietary pattern also predicted higher BMI (OR=2.2, 95% CI=0.9-5.0), LBM (3.6, 1.3-10.4), serum albumin (1.5, 0.9-2.4) and lower liver enzymes AST (0.5, 0.3-0.8) and ALT (0.6, 0.4-0.9). Using Graphical Chain Modelling, higher intake of the animal-based but lower staple-based dietary patterns were associated with better overall nutrient intake, serum vitamins A, E, lipid score, albumin, BMI and LBM suggesting that intake of this diet may provide better nutrient quality, enhancing nutritional status and metabolic proficiency, which may ultimately influence disease progression. The findings have implications for dietary guidelines for this population but further research is required. However, if these findings are true, then a predominantly animal-based diet may be ‘recommended’ for this population. Moreover, the longer term implications of high fat intake associated with the animal based dietary pattern on obesity and associated risks should be considered. This poses a challenge to imperatively weigh up the longer term risks of the overall population profile crucial for public health

The association between dietary consumption, anthropometric measures and body composition of rural and urban Ghanaian adults: A comparative cross-sectional study

Overweight and obesity have become threats to public health in all regions across the globe including sub-Saharan Africa where prevalence used to be low. Policies to regulate the food environment and promote healthy food consumption look promising to reducing the prevalence of obesity but in Ghana there is not enough data to elicit a policy response. This study assessed the association between dietary consumption, anthropometric measures, body composition and physical activity among rural and urban Ghanaian adults

Mapping Obesogenic food environments in South Africa and Ghana: Correlations and contradictions

In sub-Saharan Africa, urbanisation and food systems change contribute to rapid dietary transitions promoting obesity. It is unclear to what extent these changes are mediated by neighbourhood food environments or other factors. This paper correlates neighbourhood food provision with household consumption and poverty in Khayelitsha, South Africa and Ahodwo, Ghana. Georeferenced survey data of food consumption and provision were classified by obesity risk and protection. Outlets were mapped, and density and distribution correlated with risk classe

Knowledge and practices of dietary iron and anemia among early adolescents in a rural district in Ghana

Abstract The study assessed knowledge and practices of dietary iron intake and anemia among early adolescents in the Asante‐Akim Municipality of Ghana. A cross‐sectional study was conducted among 137 adolescents, aged 10–14 years. Structured questionnaire was used to collect data on sociodemographic, knowledge of iron, and anemia, and iron intake practices. Hemoglobin levels were determined using Hemocue 301. Data were analyzed using descriptive, chi‐square test, and binary logistics regression. The mean age of participants was 11.5 years. About 40% had knowledge of iron deficiency anemia, 29.4% knew anemia causes, 86% knew symptoms of anemia, and 35% knew anemia consequences. Although 41.2% of participants knew its prevention as eating iron‐rich foods, 31.4% knew the food sources of iron, and 4.4% mentioned animal‐based foods as rich sources, with the bulk (27%) mentioning plant‐based foods instead. Moreover, 18.2% knew iron enhancers, while 0.7% knew iron inhibitors. More chicken consumers (72.2%) than nonconsumers (56.6%) met the Estimated Average Requirement for dietary iron intake (Chi‐square 3.4, p = .073), while more dried fish consumers (88%) than nonconsumers (66.7%) had normal hemoglobin levels (Chi‐square 4.5, p = .050). Knowledge of food sources of iron and iron‐rich foods was positively associated with intake of chicken, fresh fish, and dried fish. Moreover, lower knowledge of iron‐based food sources (β = −1.015, p = .020) and iron‐rich foods (β = −2.188, p = .015) was inversely associated with beef intake. Anemia was negatively associated with chicken (β = −0.310, p = .416) and dried fish (β = −1.299, p = .045) consumption. Majority of the adolescents had low knowledge of iron. Chicken and dried fish intake reduced the risk of anemia development. Our study may be the first to assess knowledge on iron, anemia, and its impact among young Ghanaian adolescents. Our findings provide insights into this topic, calling for to improve knowledge, and practices on anemia in Ghanaian adolescents

Dietary Diversity and Nutritional Status of Adolescents in Rural Ghana

Background: The rapid biological and physical changes during adolescence require adequate nutrient intake. This study assessed dietary diversity and nutritional status of adolescents living in selected rural areas in Ghana. Method: In this cross-sectional study, 137 young adolescents, aged 10 to 14 years were recruited. Structured questionnaire was used to collect data on sociodemographic, household size and food intake practices. A multiple past 24-hour recall was used to estimate the micronutrients intake. Haemoglobin and anthropometry data were assessed. Dietary diversity score was assessed with 10 food groups described by Food and Agricultural Organization. Descriptive, chi-square, binary regression and partial correlation were used in the data analysis. Results: The prevalence of underweight was 5.5%, overweight 5.8% and anaemia 29.9%. The mean dietary diversity score was 3.8 ± 0.8 and about 84.7% of participants had inadequate dietary diversity. Proportions of adolescents who consumed from the different food groups over a 24-hour period were: grains, white roots and tubers, plantain (100%); pulses (10.2%); nuts and seeds (34.1%); dairy (8%); meat, poultry and fish (86.9%); eggs (7.3%); dark green leafy vegetables (29.9%); other vitamin-A rich fruits and vegetables (2.2%); other vegetables (81%); other fruits (7.3%). Dietary diversity scores were positively and significantly correlated with intake of micronutrient, with correlation coefficients of .169, .186, .191, .173 and .175 for vitamin A, niacin, vitamin B 6 , iron and zinc, respectively. Meal skipping (AOR = 12.2, P  < .001, 95% CI: 3.6-41.7) and snacking (AOR = 5.0, P  = .007, 95% CI:1.6-16.7) increased odds of inadequate dietary diversity. Conclusion: The high prevalence of inadequate dietary diversity was positively related to meal skipping and snacking among adolescents. Dietary diversity score was significantly related to the intake of vitamin A, niacin, vitamin B 6 , iron and zinc. The prevalence of anaemia among our study participants is of public health concern. Adolescents should be encouraged both at home and school to eat from diverse food groups to promote adequate intake of micronutrients

Patterns of Dietary Iron Intake, Iron Status, and Predictors of Haemoglobin Levels among Early Adolescents in a Rural Ghanaian District

Introduction. Early adolescents are vulnerable to anaemia due to lean body mass and menarche. The study assessed patterns of dietary iron intake, iron status, and predictors of anaemia among early adolescents. Method. One hundred and thirty-seven early adolescents were randomly selected in a rural district in Ghana. Multiple-pass 24-hour recall, iron food frequency questionnaire consisting of 27 food items, and semistructured questionnaire were administered. Variables include sociodemographics, dietary factors, and laboratory investigation including haemoglobin, ferritin, and C-reactive protein examination. Statistical Package for the Social Sciences (SPSS) software was used to calculate odds ratio and perform Mann–Whitney U test, chi-square (X2) test, exploratory factor analysis, and partial correlation (r) tests. Results. Participants had mean age of 11.5 years. Three iron dietary patterns explaining 28.7% of the total variance were identified: iron dietary pattern 1 (11%) composed of iron-rich, iron-enhancing, and iron-inhibiting foods; iron dietary pattern 2 (9.9%) comprised of iron-rich, iron-enhancing, and non-iron-inhibiting foods; and iron dietary pattern 3 (7.1%) consisting of stinging nettle, iron-inhibiting foods, non-iron-enhancing foods, non-cocoyam leaves, and non-turkey berries. Meal skipping (X2 = 5.7, p0.05), snacking (β = 0.484, p>0.05), and junior high school (JHS) education (β = 0.544, p>0.05). Partial correlation showed statistically significant relationship between iron dietary pattern 1 and dietary iron (r = −0.234, p<0.01), iron dietary pattern 2 and dietary iron (r = -0.198, p<0.05), iron dietary pattern 2 and vitamin C (r = -0.201, p<0.05), and haemoglobin and ferritin (r = −0.178, p<0.05). Conclusion. Meal skipping, guardian educational status, and number of times of eating a day were significantly associated with dietary iron intake. Meal skipping, snacking, and adolescents with JHS education were positively associated with anaemia

The impact of different dietary patterns on nutritional status and metabolic integrity in asymptomatic people living with HIV infection in South Africa

Adequate nutritional status promotes optimal structure and function. In PLWH, few studies on the impact of dietary intake on nutritional and metabolic status have been undertaken. This cross-sectional secondary data analysis examined how different dietary patterns influenced nutritional and metabolic integrity in asymptomatic PLWH in the North-West Province of South Africa. Dietary data were collected using validated QFFQ. Data analysis was by SPSS version 14. Dietary and nutrient patterns were generated using Principal Component Analysis. Though asymptomatic, marked biochemical differences depicting altered metabolism and inflammation were observed in PLWH compared to the uninfected. PLWH also showed an anthropometric profile that depicted altered body composition and abnormal fat distribution. Four dietary patterns: animal-based, ‘recommended’, staple, and the Carbohydrate, Vegetable and Legumes (CVL) based were observed in both PLWH and the uninfected with slight differences. In PLWH, the animal-based similar to the CVL pattern was associated with better overall nutrient intake (r=0.5, p<0.001) and selected nutrients, including energy (r=0.3, p<0.001), protein (r=0.6, p<0.001), iron (r=0.5, p<0.001), zinc (r=0.6, p<0.001) and vitamin A (r=0.5, p<0.001), compared to the other dietary patterns. The animal based dietary pattern also predicted higher BMI (OR=2.2, 95% CI=0.9-5.0), LBM (3.6, 1.3-10.4), serum albumin (1.5, 0.9-2.4) and lower liver enzymes AST (0.5, 0.3-0.8) and ALT (0.6, 0.4-0.9). Using Graphical Chain Modelling, higher intake of the animal-based but lower staple-based dietary patterns were associated with better overall nutrient intake, serum vitamins A, E, lipid score, albumin, BMI and LBM suggesting that intake of this diet may provide better nutrient quality, enhancing nutritional status and metabolic proficiency, which may ultimately influence disease progression. The findings have implications for dietary guidelines for this population but further research is required. However, if these findings are true, then a predominantly animal-based diet may be ‘recommended’ for this population. Moreover, the longer term implications of high fat intake associated with the animal based dietary pattern on obesity and associated risks should be considered. This poses a challenge to imperatively weigh up the longer term risks of the overall population profile crucial for public health.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Effect of 12 weeks consumption of palm weevil larvae and orange-fleshed sweet potato fortified biscuit on nutritional status and cognitive performance of school children in Kumasi, Ghana

Micronutrients are important for improving the physical growth and cognition of school-aged children. Food fortification strategies using locally available and consumed micronutrient rich foods such as edible insects can be cost effective and sustainable in improving nutritional and cognitive outcomes in school children. The study evaluated the impact of biscuits fortified with palm weevil larvae and orange-fleshed sweet potato on cognitive performance and nutritional status of school children from low income families in an urban setting in Ghana. A 12-week randomized, blinded controlled trial was conducted. 102 school children aged 6-11 years were assigned to consume either the fortified biscuits or non-fortified biscuits. Raven’s cognition test, anthropometrics, hematological and biochemical parameters were assessed at baseline and at the end of the study. After 12 weeks of intervention, there were no statistically significant differences in the means of the nutritional outcomes and cognitive performance between the treatment and control groups (p>0.05). However, significant increase in mean levels of serum ferritin (Baseline: 26.15 ± 18.42 µg/L, Endline: 42.63 ± 19.54 µg/L, mean increase: +16.48 µg/L, p=0.001), weight-for-age (Baseline: -0.37 ± 0.97, Endline: -0.11 ± 0.91, mean increase: +0.26, p<0.0001), and Raven’s cognition test score (Baseline: 14.22 ± 4.93, Endline: 16.35 ± 4.40, mean increase: +2.13, p<0.0001) were observed within the treatment group compared to the control group where significant increase was observed in only the Ravens cognition test score (Baseline: 14.79 ± 4.57, Endline: 15.95 ± 5.32, mean increase: +1.16, p<0.029). Moreover, the mean increase in cognition score was higher in intervention (+2.13) than control (+1.16) children. Results from binary logistic regression showed that although statistically insignificant, children in the treatment group had lower odds of iron deficiency (AOR= 0.7, p = 0.545, 95%CI= 0.2-2.4). In conclusion, consumption of the fortified biscuit significantly improved serum ferritin and weight-for-age in the school-aged children within the treatment group. Improvement in cognitive test score was also higher in the treatment group than the control group