Food supplementation among HIV-infected adults in Sub-Saharan Africa: Impact on treatment adherence and weight gain

This is the author's manuscript of an article published in the Proceedings of the Nutrition Society.Sub-Saharan Africa has the highest proportion of undernourished people in the world, along with the highest number of people living with HIV and AIDS. Thus, as a result of high levels of food insecurity many HIV patients are also undernourished. The synergism between HIV and undernutrition leads to poor treatment adherence and high mortality rates. Undernutrition has a debilitating effect on the immune system due to key nutrient deficiencies and the overproduction of reactive species (oxidative stress), which causes rapid HIV progression and the onset of AIDS. Therapeutic food supplementation used in the treatment of severe acute malnutrition is being applied to HIV palliative care; however, little biochemical data exist to highlight its impact on oxidative stress and immune recovery

Knowledge and Determinants of Fruit and Vegetable Consumption among Adults in Hohoe Municipality, Ghana

The World Health Organization (WHO) recommends that a person consumes at least 400g of Fruit and Vegetable (FV) daily to prevent chronic disease risk. We assessed knowledge of current WHO guidelines and other determinants of FV intake among adults (≥ 18 years, n = 397) in Hohoe Municipality, Ghana. Face-to-face interviews using a questionnaire adopted from WHO Risk Factor Surveillance System were undertaken. Knowledge of FV daily servings and determinants of intake were evaluated by descriptive statistics and binary logistic regression. There was a 99.2% response rate with approximately 9% of participants correctly stating the WHO daily recommended amount (P = .296). Most (54%) of respondents’ FV intake was affected by unavailability of desired choice (P = .050). Odd of inadequate consumption for persons aware of adequate amount was 1.97 (95% CI: 0.64, 6.05, P = .234) higher than persons without awareness. Participants with problems accessing their desired choice of FV had 0.59 odds (95% CI: 0.36, 0.95, P = .030) of consuming inadequate amount compared to those with easy access. Adequate FV intake depends on availability of consumer preference regardless of knowledge of recommendations. Individual FV cultivation is relevant for availability of preferred choice and adequate consumption for NCDs risk reductions among Ghanaians

Epidemiological and nutrition transition in developing countries: impact on human health and development

Whereas common infectious and parasitic diseases such as malaria and the HIV/AIDS pandemic remain major unresolved health problems in many developing countries, emerging non-communicable diseases relating to diet and lifestyle have been increasing over the last two decades, thus creating a double burden of disease and impacting negatively on already over-stretched health services in these countries. Prevalence rates for type 2 diabetes mellitus and CVD in sub-Saharan Africa have seen a 10-fold increase in the last 20 years. In the Arab Gulf current prevalence rates are between 25 and 35% for the adult population, whilst evidence of the metabolic syndrome is emerging in children and adolescents. The present review focuses on the concept of the epidemiological and nutritional transition. It looks at historical trends in socio-economic status and lifestyle and trends in nutrition-related non-communicable diseases over the last two decades, particularly in developing countries with rising income levels, as well as the other extreme of poverty, chronic hunger and coping strategies and metabolic adaptations in fetal life that predispose to non-communicable disease risk in later life. The role of preventable environmental risk factors for obesity and the metabolic syndrome in developing countries is emphasized and also these challenges are related to meeting the millennium development goals. The possible implications of these changing trends for human and economic development in poorly-resourced healthcare settings and the implications for nutrition training are also discussed

Is Geophagia a Health-Seeking Behavior or an Ethnic Remedy towards Greater Personal Resilience?

Objective: We investigated if Geophagia was a health-seeking behavior or a socio-cultural remedy towards enhanced personal resilience. Method: We used a sample size of 2,000 with 90% power to detect an effect size of 30% at significance level of 5%. We randomly selected one or more district, municipality or metropolitan area from each of the 10 regions (Rosemary and Valadez, 2013). We randomly selected one or more communities from each of that and then use the random walk method to evaluate households within each community till the quota for the region was met (Milligan, et al., 2004). Regional comparisons were made possible due to the stratified and random selection of representations that were similar in characteristics such as being urban or rural, then ethnicity, religion and gender. We obtained Ethical Approval to conduct the assessment. Result: The result shows that Geophagia is a cultural nutritional reality which is practiced widely in Ghana. It also appears to be a health-seeking behavior that seems to enhance the resilience of the practitioners against certain health challenges. Discussion: The research on Geophagia needs to be reconsidered without any prejudicial biases to reflect the true cultural and health reasons for it. Conclusion: Geophagia is not a result of food insecurity or food scarcity. It is a nutritional habit which may require more than the presence of food to break it

Contribution of scaling up nutrition Academic Platforms to nutrition capacity strengthening in Africa: local efforts, continental prospects and challenges

Addressing contemporary nutrition problems often require application of knowledge from multiple disciplines. The scaling up nutrition (SUN) movement harnesses multiple sectors for effective global and in-country planning and implementation. Although the role of knowl- edge networks (academia and research institutions) is recognised, the how of engaging knowl- edge networks in the current SUN architecture is only now becoming apparent. For relevant sectors to play their roles effectively, observed capacity gaps, particularly in developing coun- try settings, need to be addressed. The present paper presents the work being undertaken by the Ghana SUN Academic Platform, a local knowledge network, towards strengthening nutrition capacity in Ghana. The Platform presently provides technical support, evidence and capacity towards scaling up effective nutrition interventions in Ghana and beyond. The data presented draws heavily on the observations and collective experiences of the authors in practice, com- plemented by a review of relevant literature. The ultimate goal of the AP is to build capacity of professionals from nutrition and cognate sectors (including planning, agriculture, health, economics, research and academia). This is an essential ingredient for effective and durable SUN efforts. The paper recognises that both disciplinary and interdisciplinary capacity is required for effective SUN efforts in Africa, and offers an approach that utilises cross-sector/inter-professional, peer-learning and experiential learning initiatives

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4% (62.3 (55.1–70.8) million) to 6.4% (58.3 (47.6–70.7) million), but is predicted to remain above the World Health Organization’s Global Nutrition Target of <5% in over half of LMICs by 2025. Prevalence of overweight increased from 5.2% (30 (22.8–38.5) million) in 2000 to 6.0% (55.5 (44.8–67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic

Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017

A double burden of malnutrition occurs when individuals, household members or communities experience both undernutrition and overweight. Here, we show geospatial estimates of overweight and wasting prevalence among children under 5 years of age in 105 low- and middle-income countries (LMICs) from 2000 to 2017 and aggregate these to policy-relevant administrative units. Wasting decreased overall across LMICs between 2000 and 2017, from 8.4 (62.3 (55.1�70.8) million) to 6.4 (58.3 (47.6�70.7) million), but is predicted to remain above the World Health Organization�s Global Nutrition Target of <5 in over half of LMICs by 2025. Prevalence of overweight increased from 5.2 (30 (22.8�38.5) million) in 2000 to 6.0 (55.5 (44.8�67.9) million) children aged under 5 years in 2017. Areas most affected by double burden of malnutrition were located in Indonesia, Thailand, southeastern China, Botswana, Cameroon and central Nigeria. Our estimates provide a new perspective to researchers, policy makers and public health agencies in their efforts to address this global childhood syndemic. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

Author Correction: Mapping local patterns of childhood overweight and wasting in low- and middle-income countries between 2000 and 2017 (Nature Medicine, (2020), 26, 5, (750-759), 10.1038/s41591-020-0807-6)

An amendment to this paper has been published and can be accessed via a link at the top of the paper. © 2020, The Author(s)

The food multimix concept: potential of an innovative food based approach on nutritional status in pregnant women in resource-poor communities

RATIONALE & OBJECTIVES: The food multimix (FFM)concept states that limited food resources can be combined using scientific knowledge to meet nutrient needs of vulnerable groups at low cost utilizing the ‘nutrient strengths’ of individual or candidate foods in composite recipes within a cultural context. METHODS: The method employed the food-to-food approach for recipe development using traditional food ingredients. Recipes were subjected to proximate and micronutrient analysis and optimized to meet at tleast 40% of recommended daily intakes. End products including breads, porridge and soup were developed. RESULTS: FMM products were employed in a feeding trial among 120 healthy pregnant women in Gauteng, South Africa resulting in improvements in serum iron levels from baseline values of 14.59 (=/-7.67) umol/L and 14.02 (=/-8.13) umol/L for control and intervention groups (p=0.71), to 16.03 (=/-5.67) umol/L and 18.66 (=/-9.41) umol/L (p=0.19). The increases from baseline to post-intervention were however statistically significant within groups. Similarly Mean Cell Volume values improved from baseline as well as serum ferritin and transferritin levels. CONCLUSION: The FMM concept has potential value in feeding programs for vulnerable groups including pregnant and lactating mothers