World Nutrition

Introduction to the first issue of World Nutrition for 2024

Ted Greiner — 2024-03-29

Life style, health seeking behaviour and nutritional status of commercial vehicle drivers in Port Harcourt, Nigeria

Ope Zacchaeus Adeyanju — 2024-03-29

Background
Health seeking behaviour, lifestyle characteristics and the working conditions of commercial vehicle drivers often foster unhealthy habits and increase their vulnerability to health inequalities, including overweight, obesity, cardiovascular and metabolic disorders.
Objective
The objective of this study was to examine the life style, dietary habit, health seeking behaviour and nutritional status of commercial vehicle drivers in Port Harcourt, Nigeria.
Methods
This descriptive and cross-sectional study adopted a simple random sampling technique to recruit 202 commercial vehicle drivers in Port Harcourt, Nigeria. A semi-structured interviewer-administered questionnaire was used to obtain information on demographics, life style and health care characteristics of the commercial vehicle drivers. The anthropometric indices (weight and Height) of the drivers were obtained and their body mass index (BMI) was determined using WHO classification. Data were analysed using descriptive and inferential statistics, and level of significance was set at p= 0.05.
Results
Mean age of the drivers was 43 ± 5.2 years and majority (86%) of them have completed secondary education. The majority (59%) consume soft drinks at least once per week and 85% eat at least one meal outside their home daily, while 16% and 49% patronize herbal medicine/concoction and visit the pharmacy or chemist store to purchase drugs respectively as first point of care when sick. The prevalence of overweight and obesity among the commercial drivers was 20% and 33% respectively. There was a statistically significant relationship between elevated BMI and respondent’s age (p<0.05), level of education (P=0.05), physical inactivity (P<0.01) and frequency of alcohol consumption (P<0.05).
Conclusions
This study confirms high prevalence of overweight and obesity among the commercial vehicle drivers and its associated factors of poor nutritional habits, health and life style characteristics. Therefore, a comprehensive nutritional programme including behavioural change and communication that is context-specific targeted at commercial drivers should be implemented.

Maternal hygiene practices amongst mothers of infants and young children in Mohali (Punjab): A cross sectional study

Dr. Ritu Pradhan — 2024-03-29

The United Nations (UN) General Assembly recognized the human right to water and sanitation in 2010, emphasizing the importance of sufficient, safe, acceptable, physically accessible, and affordable water for all individuals. Ensuring these criteria is vital for the health and well-being of communities, particularly infants and young children. This study aims to assess WASH practices amongst mothers of children aged 0-2 years in Mohali District, Punjab, India, and their implications for child health during the COVID-19 pandemic. During the administration of questionnaire, prevailing perceptions and practices about breastfeeding were assessed. This would identify the need for targeted education and support initiatives to ensure informed decision-making among mothers. Our findings also revealed appropriate WASH practices amongst majority of surveyed mothers (88.4%). This was found to be closely linked to their educational qualifications. Maternal education and awareness about appropriate WASH practices and importance of COVID vaccination for mothers of infants and young children may play a pivotal role in implementing WHO recommendations. Furthermore, the research highlights the necessity of continuous monitoring and evaluation of WASH practices among mothers, as they are the primary caregivers for their children. Inadequate hygiene practices among women can have profound consequences on child nutrition and overall health. Therefore, proactive interventions to enhance WASH practices among women are crucial for the future well-being of society.

Perceptions and experiences of an intervention to improve diets of women and young children in Ghana

Sandra B Kushitor — 2024-03-29

Background
Efficacious integrated intervention strategies to address the drivers of malnutrition at multiple levels are hardly implemented at scale, although opportunities for cross-sectoral action exist. In 2020, the Improved Feeding Practices (IFP) Project was implemented in Ghana to improve the dietary diversity and well-being of women of reproductive age (15-49 years) and children >2 years.
Objective
This paper reports the perceptions and experiences of project beneficiaries and the lessons learned from the IFP project.
Methods
Using a socio-ecological framework, data from the IFP project documents (n=8) and in-depth interviews with key stakeholders, including local government officers, and direct and indirect beneficiaries (n=61), were triangulated to construct an evidence-based overview of the implementation of the complementary strategies of the IFP project. The interviews explored respondents' knowledge, experiences of the project activities, and perceptions of how the project affected their lives. The data were analysed and synthesized thematically using ATLAS.ti.
Results
The IFP project envisaged an impact pathway through promoting community- or home-based nutrient-rich crop production and poultry to enhance diet quality, child care and feeding practices. Multi-sectoral partners facilitated training and service delivery at community, farm, facility, and household levels. Beneficiaries reported an overall positive experience of participating in the project, including enhanced dietary knowledge, capacity to produce and use eggs and orange fleshed sweet potatoes (OFSP), earned revenues, and access to nutritious foods. Caregivers reported that the IFP project contributed to enhancing children’s diet quality, reduced disease incidence, and improved child growth. Community-level program implementers experienced capacity strengthening. The dry season, increased poultry feed input prices, diseases (such as fowl pox, Newcastle and smallpox), and poultry deaths, limited the scale of benefits. Key implementation lessons include leveraging local resources to produce poultry feed at home, crossbreeding local and commercial poultry, and enhancing disease management, leading to improved potential for project sustainability.
Conclusions
Overall, the communities reported a positive experience of an integrated nutrition-sensitive agriculture (NSA) intervention, leading to improved diets of households, women of reproductive age, and young children >2 years. These strategies can be adapted for use in other to improve women's and children's dietary diversity in similar settings, giving due consideration to lessons learned.

Small-scale egg and orange-fleshed sweet potato production and utilisation in selected communities in Ghana: A mixed-methods study

Helen H Habib, PhD — 2024-03-29

Background
Nutrition-related exposures during the first 1,000 days of life are a predictor of health outcomes later in life. World Vision Ghana’s ‘Improved Feeding practices for the 1,000 days’ (IFP) project aimed to improve dietary practices of women and children utilising an integrated intervention approach including nutrition, health, and agriculture strategies.
Objective
This paper reports on the production and utilisation of orange-fleshed sweet potatoes (OFSP) and eggs for improving diets of women in reproductive age and young children during the first 1,000 days of life.
Methods
Primary data from Kassena-Nankana West (KNW), Sekyere East (SE) and Kintampo South (KS) districts were triangulated with project routine data for this analysis. Univariate analyses of quantitative data from baseline and implementation monitoring data were conducted to describe the sociodemographic characteristics of beneficiaries, inputs disbursed, outputs produced, and utilisation of the food commodities. Qualitative interviews from 61 participants were transcribed, coded, and thematically analysed; these were triangulated with the quantitative data to capture main themes and findings.
Results
OFSP and egg production and consumption increased annually across beneficiary communities. In 2021, 100% of OFSP produced was consumed in KS; in SE, 95.0% was consumed and 5.0% lost to post-harvest losses. In 2022, 90% OFSP produced in KNW was consumed and 9.0% sold. In KS, 90.3% was consumed and 9.0% sold. In SE, 82.3% was consumed and 17.1% sold. Egg production at the end of the first production year (2022) was 18,720 crates in KNW, 19,680 crates in KS and 40,128 crates in SE. Egg consumption in sample households was less than 10% in 2022 and showed a decreased trend in the first half of 2023. In SE and KS, egg and OFSP production, respectively, increased, exponentially; sale for income was the most common mode of utilisation in eggs but OFSP was consumed in these districts. In KNW, climate, irrigation and socio-cultural barriers hindered the maximal production and utility of the produce, which was not observed in SE and KS, which did not have any of these identified barriers. Reported unintended benefits of production and utilisation included increased household income, food security, and availability of organic manure as a side-product of poultry.
Conclusions
The IFP project resulted in increased household level production, use and distribution of Eggs and OFSP across the three focal districts. Similar settings may benefit from this intervention by adapting the strategies to become easier for beneficiaries to better cope with likely potential barriers such as poultry mortality and water scarcity.

Availability, acceptability, and utilization of micronutrient fortification for children 6-23 months in three districts in Ghana

William E S Donkor — 2024-03-29

Background
Micronutrient deficiencies result from multiple factors, including inadequate intake of micronutrients (vitamins and minerals) from nutrient-rich diverse diets. Point-of-use fortification with a nutritional supplement powder is recommended to address micronutrient deficiencies and anemia among infants and young children (6-23 months), particularly, in low-income countries. In Ghana, about a quarter of children aged 6-59 months are anemic, or deficient in iron and vitamin A. World Vision Ghana (WVG) implemented the integrated Improved Feeding Practices (IFP) project between 2020 and 2023 in three districts in Ghana to improve diet quality and practices of women of reproductive age, and young children below age two years. One component of the project involved the distribution of a nutritional supplement powder (KOKO Plus). This is the second in a series of four papers that document the implementation and outcomes of the IFP project; the other papers are published in this journal. The current paper assessed the availability, acceptability, and utilization of KOKO Plus to households who participated in the IFP project as well as lessons learned from implementing the intervention.
Methods
A mixed-methods design was used, triangulating primary and secondary data. Secondary data originated from review of IFP project documents, including project mid-year and annual reports, and implementation plans across the three interdependent components of the IFP project. Primary data were obtained from interviews in six purposively selected communities. Key informants included WVG staff, community volunteers, and local government agency staff from health and agriculture sector agencies, and beneficiaries of the intervention. Interview respondents answered questions on the project’s mechanism for KOKO Plus distribution, participant experiences of purchasing and using KOKO Plus, perceived benefits of using KOKO Plus, and lessons learned about KOKO Plus from the IFP project. Beneficiaries also provided information on their perceptions of KOKO Plus acceptability and adverse outcomes.
Results
The project distributed KOKO Plus free of charge to almost 14,000 (13,942) children, more than its target (4,900). In addition, Village-Based Entrepreneurs (VBE) sold 192,092 sachets of KOKO Plus in the project communities. The KOKO Plus value chain involved WVG purchasing the KOKO Plus from the Ghanaian manufacturer and supplying it to VBE’s either in their respective communities, or at distribution centers in their respective WVG district office. KOKO Plus promotion and marketing was led by trained VBE’s, VBE supervisors, and Community Based Organizations across multiple settings (homes, child welfare clinics, markets, community durbars, and religious gatherings). There was high acceptability of KOKO Plus. Mothers attributed their acceptance of KOKO Plus to its potential health and nutrition benefits for children. They also attributed increased child weight, and less frequent illness, to feeding meals that included KOKO Plus to their young children. KOKO Plus was added to the diverse local meals fed to young children. Diarrhea was the only mentioned adverse report, albeit rarely. At the end of the IFP project, WVG established a fund to ensure sustainable distribution of KOKO Plus in the project communities.
Conclusions
The IFP project established a KOKO Plus value chain, increasing availability, accessibility, acceptability, and utilization of KOKO Plus in the project communities. VBE’s successfully distributed KOKO Plus with support from community volunteers, and health care workers. This approach to KOKO Plus distribution is feasible and sustainable and is recommended for similar contexts.

The impact of Mediterranean diet on colorectal cancer recurrence following chemotherapy treatment: A systematic review

Caitlyn A Simtion — 2024-03-29

Background
Previous research suggests that the Mediterranean diet (a diet high in fruits and vegetables, lean protein, legumes, whole grains, and olive oils) provides protective effects against colorectal cancer. However, there has been little research to determine how the Mediterranean diet could help prevent the recurrence of colorectal cancer following chemotherapy treatment.
Objective
This systematic review assesses the impact of the Mediterranean diet on the rate of recurrence following colorectal cancer treatment.
Methods
A systematic search on PubMed, UNE Library, and EMBASE was conducted to find all research studies assessing the Mediterranean diet and its effects on colorectal cancer and post-treatment effects. Article titles and abstracts were screened for relevance in addition to full article screening for eligibility and were quality rated based on ANDEAL criteria.
Results
Sixteen studies met the eligibility criteria and, as a result, were included. One study assessed lifestyle factors; three studies assessed the components of the Mediterranean diet and their effects on colorectal cancer; one study assessed the dietary inflammatory index and its impact on colorectal cancer; five studies assessed adherence to the Mediterranean diet; four studies assessed diet following cancer treatments; and two studies assessed long-term nutritional intervention on cancer recurrence. The results revealed that the Mediterranean diet has a positive impact on reducing the risk of colorectal cancer, with potential health benefits following treatment for colorectal cancer. Limitations in analyzing results include being a time-locked study, inability to access all articles on the topic, use of English-only articles, and limitation of search terms utilized.
Conclusions
While previous research reveals evidence that the Mediterranean diet reduces the risk of colorectal cancer, there is compelling data to suggest that adherence the Mediterranean diet, as a normal diet pattern following treatment for colorectal cancer, could reduce the rate of recurrence. Future research is needed to examine the effects of the Mediterranean diet following colorectal cancer treatment.

The contribution of the National Nutrition Policy in addressing Ghana's social determinants of health and nutrition inequalities

Sarah Gyamfua Larbi — 2024-03-29

One of the major challenges for developing countries is growing economic prosperous while eradicating poverty and lowering social and health inequalities. The National Nutrition Policy of Ghana (NNP) was launched in July 2016 to ensure optimal nutrition for people living in Ghana, promote child survival, and enhance capacity for economic growth and development. A review of the policy was conducted in 2018 where the effectiveness of the policy in meeting its objectives was ranked as poor, impacting negatively on the social determinants of health. This article analyzes the NNP by using the Kingdon Framework to determine how problems, politics, and the policy itself can act as a tool to address the factors that have a significant influence on an individual’s health and well-being, especially the marginalized in society.

Public health services have never taken full advantage of the potential for breastfeeding to save lives

Ted Greiner — 2024-03-29