Food insecurity, a perceived barrier to healthy eating in the Lake Victoria Region, Kenya: Findings from a qualitative study

Consumption of poor-quality diets was noted as prevalent in the Lake Victoria Region, Kenya. As a strategy to communicate desirable change and promote healthy eating in the region, a 30-member panel of policymakers and implementers developed and proposed 12 food-based dietary guidelines (FBDGs) in 2017-2018. The objective of this study was to assess barriers in adopting the proposed FBDGs amongst community members in the lowlands of Kisumu and Homa Bay counties. Qualitative, descriptive cross-sectional design was used to collect data from 72 focus-group discussions (FGD). The FGD was conducted among 216 school going children (10-13y), 216 high school students (15-18y), 207 adult males (26-74y) and 211 females (18-71y). The participants were asked to state whether the proposed FBDGs reflected their daily dietary practices? If the answer was no, the FGD participants were asked to elaborate on the perceived barriers. Each FGD consisted of 8-12 participants. The demographics of FGD participants were collected before the start of FGD sessions. All FGD proceedings were audio-recorded and transcribed verbatim. Demographic information of participants was analyzed and presented using descriptive statistics. The FGD responses were coded and analyzed based on the main code, the barriers. Barriers to healthy eating in the study area were mainly linked to low production of food, food unavailability and inaccessibility. Specific factors which contributed to the food insecurity situation included; dry and sunny weather, seasonality in food availability, limited resources to secure potential farmland with fences, gender influence on land use, high cost of food, lack of money to purchase food, low income, sale of farm produce with resultant inadequate quantities of food consumed and inappropriate meal composition. Food insecurity was a perceived barrier to healthy eating in the lowlands of the Lake Victoria region. This research suggests the need to address food systems and economic structures to improve food production, distribution, accessibility and consumption in the region. Coding was done with the aid of NVivo8 (QSR International Pty Ltd Version 8, 2008). This study was registered with the Kenyan National Commission for Science Technology and Innovation (NACOSTI/P/18/12634/22291).&nbsp

Anthropometric characteristics and nutritional status of older adults in the Lake Victoria Basin of East Africa: Region, sex, and age differences

Background: Malnutrition, either as undernutrition or overnutrition, leads to detrimental alterations in body composition. The objective of this study was to investigate selected anthropometric measurements, and the nutritional status of older men and women living in the Lake Victoria Basin. This was a cross-sectional study.Setting: The setting was selected rural and urban areas of Kisumu, Jinja, and Mwanza, in Kenya, Uganda and Tanzania, respectively.Subjects: The subjects were older adults (227 men and 310 women) aged ≥ 60 years.Outcome measures: The outcome measures were weight, height, arm span, mid-upper-arm circumference (MUAC) and triceps skin-fold thickness (TSF). Body mass index (BMI) and arm muscle area (AMA) were computed using standard equations.Results: The results show that older adults in the three regions were significantly different (p-value < 0.05) in all anthropometric measurements, except MUAC. The women had significantly higher (p-value < 0.05) BMI, TSF, and MUAC, than the men. Negative slopes indicated a decline in all anthropometric measurements with age. Overall underweight (BMI < 18.5 kg/m2) was 26.4%, 58.3% were normal (BMI 18.5-24.9 kg/m2), 10.8% were overweight (BMI 25-29.9 kg/m2), and 4.5% were obese (BMI ≥ 30 kg/m2). Older men (29.5%) were significantly more underweight (p-value < 0.05) than older women (24.2%), with overweight (12.5%) and obesity (6.8%) being significantly higher (p-value < 0.05) in older women.Conclusion: The findings suggest energy depletion and loss of muscle mass, with significant differences in the three regions, and in the sex and age groups. A small proportion was overweight and obese. The decline in anthropometric measurements with age indicates poor nutritional status with aging. Thus, nutrition and health interventions should be specific to regions

Photoreceptors in diabetic retinopathy

Although photoreceptors account for most of the mass and metabolic activity of the retina, their role in the pathogenesis of diabetic retinopathy has been largely overlooked. Recent studies suggest that photoreceptors might play a critical role in the diabetes-induced degeneration of retinal capillaries, and thus can no longer be ignored. The present review summarizes diabetes-induced alterations in photoreceptor structure and function, and provides a rationale for further study of a role of photoreceptors in the pathogenesis of the retinopathy