Arne Oshaug

Food variety, socioeconomic status and nutritional status in urban and rural areas in Koutiala (Mali).

OBJECTIVEnThe purpose of this study was to analyse the associations between the food variety score (FVS), dietary diversity score (DDS) and nutritional status of children, and to assess the associations between FVS, DDS and socioeconomic status (SES) on a household level. The study also assessed urban and rural differences in FVS and DDS.nnnDESIGNnCross-sectional studies in 1994/95, including a simplified food frequency questionnaire on food items used in the household the previous day. A socioeconomic score was generated, based on possessions in the households. Weight and height were measured for all children aged 6-59 months in the households, and anthropometric indices were generated.nnnSUBJECTS AND SETTINGnThree hundred and twenty-nine urban and 488 rural households with 526 urban and 1789 rural children aged 6-59 months in Koutiala County, Sikasso Region, Mali.nnnRESULTSnChildren from urban households with a low FVS or DDS had a doubled risk (OR>2) for being stunted and underweight. Those relations were not found in the rural area. There was an association between SES and both FVS and DDS on the household level in both areas. The FVS and DDS in urban households with the lowest SES were higher than the FVS and DDS among the rural households with the highest SES.nnnCONCLUSIONSnFood variety and dietary diversity seem to be associated with nutritional status (weight/age and height/age) of children in heterogeneous communities, as our data from urban areas showed. In rural areas, however, this association could not be shown. Socioeconomic factors seem to be important determinants for FVS and DDS both in urban and rural areas. FVS and DDS are useful variables in assessing the nutritional situation of households, particular in urban areas.

Nutrient composition and nutritional importance of green leaves and wild food resources in an agricultural district, Koutiala, in Southern Mali

This paper discusses the nutrient composition and the nutritional importance of green leaves and wild gathered foods in an area with surplus food production in Mali. In this West African country, there is little information about the nutrient composition and the nutritional quality of foods in general, and of wild gathered foods in particular. Food frequency was collected in two cross-sectional surveys. Focus group discussions with women in the area were used to collect information about seasonality, availability and preparation of various foods. Selected food samples were collected for chemical analysis of nutrient composition. The food samples of green leaves (Adansonia digitata, Amaranthus viridis, Tamarindus indica, Allium cepa), seeds and flour (Parkia biglobosa) and fruits (Tamarindus indica) were analysed for water, energy, fat, protein, minerals, amino acids and carotenoids. Availability and use of the foods varied with seasons. In the rainy season, wild gathered foods (e.g. A. digitata) were used as much as fresh cultivated foods (e.g., A. viridis and A. cepa). The wild food resources were more frequently used in rural than in urban areas, with A. digitata as the dominating green leaves. Green leaves were rich in energy, protein and minerals (calcium, iron). Leaves of A. viridis were, in particular, rich in beta-carotene (3290 micrograms/100 g). Chemical score in dried green leaves varied from 47 (A. cepa) to 81 (A. digitata), with lysine as the first limiting amino acid. P. biglobosa fermented seeds, with 35% fat and 37% protein were a complementary source of lysine in the diet. Based on the seasonality, the frequency of use and the nutrient contents of selected green leaves and wild gathered foods in Koutiala district, it is concluded that these traditional and locally produced foods are valuable and important nutrient contributors in the diet both in rural and urban areas, but most important in rural areas.

Validation of food variety as an indicator of diet quality assessed with a food frequency questionnaire for Western Mali

Objective: To assess the validity of two diet quality indexes—food variety score (FVS) and diet diversity score (DDS) in Western Mali.Design: In two separate studies (A and B), FVS and DDS were derived from a food frequency questionnaire (FFQ) and were compared with the same scores and with measures of nutrient adequacy derived from 2-day weighed records (WR).Setting: Two rural, adjacent villages in Mali, West Africa.Subjects: In study A (1996), 48 women and 27 men (15–59u2009y) participated. Study B (1999) included 34 women and 36 men (15–45u2009y).Results: Spearmans correlation coefficients between FVS from the FFQ and WR for men were 0.5 in study A and 0.4 in study B. The corresponding correlations for DDS were 0.2 and 0.4, respectively. Correlations for women were lower, especially in study B. Classification into quartiles was also best for men. Correlations for the two diet variety scores from the FFQ with nutrient adequacy from the WR in study A were about 0.3 for men, but lower for women. In study B, these correlations were around 0.5 for men, whereas for women there was no association.Conclusions: FVS and DDS can be assessed by our FFQ. The two diet variety scores reflect diet quality and are simple tools that can be used for monitoring. The validation study gave better results for men than for women, which has implications for further use of these instruments.Sponsorship: The Norwegian Research Council and The Stromme Foundation funded the project.

Human rights: a normative basis for food and nutrition-relevant policies

Abstract This paper explores human rights as a basis for policy formulation and planning of programmes and activities that will enhance food and nutrition security. The right to adequate food and to be free from hunger forms part of the contemporary International Bill of Human Rights as adopted by the United Nations. It is expressly provided for in the Universal Declaration of Human Rights of 1948 and in the International Convenant on Economic, Social and Cultural Rights of 1966, as well as in other more recent instruments such as the Convention of the Rights of the Child of 1989. However, neither the right to food nor other rights pertaining to nutrition as an ultimate human development objective have so far been given sufficient attention by agencies dealing with food, health and nutrition. The paper discusses the right to food as recently elaborated within the human rights bodies of the United Nations, including the notion of the three levels of state obligations: to respect, to protect and to fulfil or assist the realization of the right to food. Furthermore, the paper considers an analytical framework for food security and its expansion into ‘nutrition security’ which can form a basis for translating food and nutrition development goals into rights and obligations as they are embedded in international legal instruments. The paper proposes a framework for analysing, at household, community and national levels, both causes of and solutions to food insecurity and malnutrition, as a basis for identifying state obligations to address food and nutrition security from a human rights perspective. The centrepiece of the paper is a ‘Food and nutrition security matrix’ that can help clarify state obligations, and which countries may find useful in their attempts to find effective solutions to the nutritional problems of their people. It may also serve in the dialogue between partners of official and non-governmental development operation, so as to identify where, how and, especially, at what level external assistance can best support integrated government efforts. The paper concludes with a set of general policy recommendations.

How does the human rights perspective help to shape the food and nutrition policy research agenda

Food as a human right was first laid down 50 years ago in the Universal Declaration of Human Rights. The last 10 years, in particular, have witnessed an increased recognition of the importance of the human rights approach for designing policies and interventions that promote food and nutrition security, as evidenced by the highly visible role given to human rights at the 1996 World Food Summit. But, given that the design of effective policies and interventions is based on good analysis and information, what are the implications of the human rights approach for the food and nutrition policy research agenda? This is the question we address in this paper. We note several implications of the human rights perspective in terms of (1) new research areas, (2) new perspectives on old issues, and (3) implications for research methods.

Nutrient composition and protein quality of wild gathered foods from Mali

For developing countries only limited information is available on nutritive composition of foods in general and of gathered foods in particular. This paper presents the nutritive composition and nutritional quality of wild gathered foods from Malian Gourma. Important wild staples used by nomads were collected in the dry season. The samples included grains of Cenchrus biflorus and Panicum laetum, green leaves of the Maerua crassifolia and roots of Nymphaea lotus. C. biflorus had the highest concentrations of protein (22.1%), fat (7.3%) and gross energy (1880 kJ/100 g). Among the fractions of P. laetum the dehusked grains were richest in protein (12.4%), total carbohydrates (82.1%) and gross energy (1630 kJ/100 g). The first limiting amino acid, irrespective of the fraction of the grains, was lysine. The biological studies of the protein quality confirmed the findings in chemical analysis and calculations of chemical scores. Both methods, the calculations of chemical scores and of biological values, gave re...

Use of anthropometric measurements in assessing risk for coronary heart disease: a useful tool in worksite health screening?

The study examined the association between the anthropometric measurements body mass index (BMI), waist/hip ratio (WHR), and waist/thigh ratio (WTR) and cardiovascular risk factors, and assessed whether a combination of BMI and WHR could be used in routine screening of risk for cardiovascular arteriosclerotic disease at worksites. The data were obtained from a cross-sectional survey designed to assess the nutritional situation, with special reference to cardiovascular risk factors. The study population comprised 372 healthy men working on platforms in the North Sea. Serum cholesterol, triglyceride, fibrinogen, and blood pressure were positively related to the anthropometric variables, while high-density lipoprotein (HDL) was inversely related with them. The relations remained after adjusting for possible confounders, such as age, smoking, physical activity, and an indicator of dietary fat intake. In stepwise multiple linear regression models, BMI, WHR, and WTR were positively related to serum cholesterol, triglycerides, fibrinogen, diastolic blood pressure, and systolic blood pressure, and inversely related to HDL. When controlling for the anthropometric variables WHR and WTR, BMI was not independently related to fibrinogen and risk score. WHR and WTR were not independently related to systolic and diastolic blood pressure, and WTR was in addition not related to triglycerides when controlling for BMI. Overall, the anthropometric variables BMI and WHR were considered the best predictors for CAD risk when taking several risk factors into consideration. A joint variable between BMI and WHR, called “body score”, constituted the four categories lean, lean android, overweight gynoid, and overweight ovoid. This body score was positively associated with levels of serum lipids, fibrinogen, and blood pressure, and inversely associated with HDL. In stepwise multiple linear regression models, controlling for possible confounding variables, body score was positively related to CAD risk. Dividing the risk score into tertiles, about 51% of the lean were in the first, while 46% of the overweight ovoid were in the third tertile. Those classified as lean android or overweight gynoid had about the same distribution, namely between 31% and 39% in each tertile if the two categories were combined. These data support the hypothesis that BMI, WHR, and WTR are independent predictors for risk factors for CAD among oil workers, and that combinations of BMI and WHR are strong enough predictors to be useful in routine screening for CAD risk at worksites. Based on these findings, supported by data from the literature, a matrix aimed at screening for follow-up at worksites is proposed.

Human Milk: An Invisible Food Resource

Human milk is an invaluable food resource for infants and young children in Sub-Saharan Africa. Statistics on production of human milk at local and national levels are lacking. In this article, estimates of the quantity of human milk production in Mali, Senegal, Nigeria, and Zimbabwe were calculated. Annual production in the urban and rural areas in Mali was 13 and 17 kg per capita, respectively. National annual median production ranged from 93,000 (Zimbabwe) to 1.3 million metric tons (Nigeria), and from 9 (Zimbabwe) to 15 kg per capita (Mali). Given a value of (US)

Heaty and cooling foods in relation to food habits in a Southern Sri Lanka community

1 per liter, inclusion of human milk in calculations of the gross national product (GNP) for these countries would increase this value by more than 5% for Mali, and nearly 2% for Senegal. Human milk is a significant food source to children in this region and should be included in national food statistics due to its nutritional and economic importance.

Human resource building for the promotion of nutrition rights A cross-disciplinary challenge

According to Ayurveda, the traditional medical system observed in Sri Lanka, adherence to the principles of the hot‐cold system of food classification is important in both prevention and cure of disease. This report discusses the impact of the hot‐cold system on food behaviour in a rural community in southern Sri Lanka. In this community the hot‐cold system did not appear to have a large impact on food behaviour of healthy adults. However, during certain critical periods of life such as early childhood, pregnancy, lactation and times of disease, special considerations related to the hot‐cold system were observed. These considerations and their possible nutritional significance are discussed.