A review of food-based dietary guidelines in Africa: opportunities to enhance the healthiness and environmental sustainability of population diets

Food-based dietary guidelines (FBDGs) are important tools for promoting healthy eating and nutrition education at the population level. Currently, more than 100 countries worldwide have developed FBDGs with majority of existing FBDGs in highincome countries. However, there are a few countries in Africa which have developed FBDGs. This review describes and compares the characteristics of existing FBDGs in Africa. Data were extracted from all existing FBDGs from African countries which have been archived in the Food and Agriculture Organization’s (FAO) online repository of FBDGs. In addition, supporting documentation from other sources linked to the identified FBDGs were also reviewed. Extracted data were coded and synthesized to describe the purpose of the FBDGs, the process for developing the FBDGs, and how healthy diets were expressed in the FBDGs. In addition, the FBDGs were examined for content on considerations for planetary health, and non-dietary recommendations. A checklist was used to extract the evidence in the identified documents. Of the 47 African countries in the WHO Africa region, only eight FBDGs were identified from seven countries. South Africa had two FBDGs (including a FBDG for young children). Multi-disciplinary technical working groups were convened in developing majority of the FBDGs. The working groups utilised scientific evidence on diet-related diseases and nutrient requirements as a basis for recommendations. All the FBDGs were intended as a tool for promoting healthy diets among the lay population. The FBDGs that were reviewed included between six and sixteen dietary messages. Diet diversification was promoted as the most common recommendation across African country FBDGs. The recommendations often promoted consumption of four to six food groups communicated using text as well as images (food guide). Local availability and cultural acceptability were important values promoted as part of an optimal diet in some of the countries. However, none of the recommendations addressed environmental sustainability. Apart from South Africa, none of the FBDGs had been evaluated or revised. Across Africa, there is a need for increased focus on developing new FBDGs or revising existing ones as a tool for meeting the dietary information needs of populations at risk of malnutrition in all its forms

Review of food-based dietary guidelines in Africa: Opportunities to enhance the healthiness and environmental sustainability of population diets

Food-based dietary guidelines (FBDGs) are important tools for promoting healthy eating and nutrition education at the population level. Currently,  more than 100 countries worldwide have developed FBDGs with majority of existing FBDGs in highincome countries. However, there are a few  countries in Africa which have developed FBDGs. This review describes and compares the characteristics of existing FBDGs in Africa. Data were  extracted from all existing FBDGs from African countries which have been archived in the Food and Agriculture Organization’s (FAO) online  repository of FBDGs. In addition, supporting documentation from other sources linked to the identified FBDGs were also reviewed. Extracted data  were coded and synthesized to describe the purpose of the FBDGs, the process for developing the FBDGs, and how healthy diets were expressed in  the FBDGs. In addition, the FBDGs were examined for content on considerations for planetary health, and non-dietary recommendations. A checklist  was used to extract the evidence in the identified documents. Of the 47 African countries in the WHO Africa region, only eight FBDGs were  identified from seven countries. South Africa had two FBDGs (including a FBDG for young children). Multi-disciplinary technical working groups were  convened in developing majority of the FBDGs. The working groups utilised scientific evidence on diet-related diseases and nutrient  requirements as a basis for recommendations. All the FBDGs were intended as a tool for promoting healthy diets among the lay population. The  FBDGs that were reviewed included between six and sixteen dietary messages. Diet diversification was promoted as the most common  recommendation across African country FBDGs. The recommendations often promoted consumption of four to six food groups communicated  using text as well as images (food guide). Local availability and cultural acceptability were important values promoted as part of an optimal diet in  some of the countries. However, none of the recommendations addressed environmental sustainability. Apart from South Africa, none of the FBDGs  had been evaluated or revised. Across Africa, there is a need for increased focus on developing new FBDGs or revising existing ones as a tool for  meeting the dietary information needs of populations at risk of malnutrition in all its forms.&nbsp

Radiation-induced dermatitis among breast cancer patients undergoing adjuvant radiotherapy in Ghana

The aim of the study was to investigate radiation-induced epidermal desquamation among breast cancer patients undergoing radiotherapy with 6MV linac and Co-60 teletherapy units. Method: Quantitative data was collected using self-administered closed ended questionnaires addressing the desquamation in relation to some patient-and treatment-related factors. The Radiation Therapy Oncology Group (RTOG) criteria for acute skin toxicity was used to grade the toxicity. Chi square and logistic regression analyses were respectively used to test statistical significance and evaluate the effects of the various factors on radiation induced epidermal desquamation Results: Majority of the participants had high BMIs (overweight: 39.5 %; obese: 50 %). Patients with BMI ≥ 25 kg/m2 presented with wet desquamation (RTOG grade 2). A chi-square analysis showed a significant difference (p = 0.02) between BMI and severity of desquamation. There was no significant difference between type of treatment machine and cumulative incidence dose of desquamation (p = 0.251). The logistic regression analysis showed that patients who had undergone mastectomy (OR = 0.562) were less likely to develop wet desquamation (RTOG grade 2) on the Co-60 machine within the 20–30 Gy threshold (OR=0.981) compared to those on the linear accelerator. Patients with lower BMI (OR = 0.412,[ < 25 vs ≥30]; OR = 0.286, [25–29.9 vs ≥30]) were also less likely to develop wet desquamation compared to those with higher BMI. Conclusion: Radiation-induced epidermal desquamation is a common side effect of breast cancer patients undergoing radiotherapy. BMI has an effect on the severity of desquamation experienced during breast irradiation