Judith Kimiywe

Predictors of overweight and obesity in adult women in Nairobi Province, Kenya

BackgroundSince obesity in urban women is prevalent in Kenya the study aimed to determine predictors of overweight and obesity in urban Kenyan women.MethodsA cross-sectional study was undertaken in Nairobi Province. The province was purposively selected because it has the highest prevalence of overweight and obesity in Kenya.A total of 365 women aged 25–54 years old were randomly selected to participate in the study.ResultsHigher age, higher socio-economic (SE) group, increased parity, greater number of rooms in the house, and increased expenditure showed greater mean body mass index (BMI),% body fat and waist circumference (WC) at highly significant levels (p <0.001). Most of the variance in BMI was explained by age, total physical activity, percentage of fat consumed, parity and SE group in that order, together accounting for 18% of the variance in BMI. The results suggest that age was the most significant predictor of all the dependent variables appearing first in all the models, while parity was a significant predictor of BMI and WC. The upper two SE groups had significantly higher mean protein (p <0.05), cholesterol (p <0.05) and alcohol (p <0.001) intakes than the lower SE groups; while the lower SE groups had significantly higher mean fibre (p <0.001) and carbohydrate (p <0.05) intakes. A fat intake greater than 100% of the DRI dietary reference intake (DRI) had a significantly greater mean BMI (p <0.05) than a fat intake less than the DRI.ConclusionsThe predictors of overweight and obesity showed that urbanization and the nutrition transition were well established in the sample of women studied in the high SE groups. They exhibited a sedentary lifestyle and consumed a diet high in energy, protein, fat, cholesterol, and alcohol and lower in fibre and carbohydrate compared with those in the low SE groups.

Micronutrient Status and Dietary Intake of Iron, Vitamin A, Iodine, Folate and Zinc in Women of Reproductive Age and Pregnant Women in Ethiopia, Kenya, Nigeria and South Africa: A Systematic Review of Data from 2005 to 2015

A systematic review was conducted to evaluate the status and intake of iron, vitamin A, iodine, folate and zinc in women of reproductive age (WRA) (≥15–49 years) and pregnant women (PW) in Ethiopia, Kenya, Nigeria and South Africa. National and subnational data published between 2005 and 2015 were searched via Medline, Scopus and national public health websites. Per micronutrient, relevant data were pooled into an average prevalence of deficiency, weighted by sample size (WAVG). Inadequate intakes were estimated from mean (SD) intakes. This review included 65 surveys and studies from Ethiopia (21), Kenya (11), Nigeria (21) and South Africa (12). In WRA, WAVG prevalence of anaemia ranged from 18–51%, iron deficiency 9–18%, and iron deficiency anaemia at 10%. In PW, the prevalence was higher, and ranged from 32–62%, 19–61%, and 9–47%, respectively. In WRA, prevalence of vitamin A, iodine, zinc and folate deficiencies ranged from 4–22%, 22–55%, 34% and 46%, while in PW these ranged from 21–48%, 87%, 46–76% and 3–12% respectively. Inadequate intakes of these micronutrients are high and corresponded with the prevalence figures. Our findings indicate that nationally representative data are needed to guide the development of nutrition interventions and public health programs, such as dietary diversification, micronutrient fortification and supplementation.

Are Low Intakes and Deficiencies in Iron, Vitamin A, Zinc, and Iodine of Public Health Concern in Ethiopian, Kenyan, Nigerian, and South African Children and Adolescents?

Objective: To perform a systematic review to evaluate iron, vitamin A, zinc, and iodine status and intakes in children and adolescents (0-19 years) in Ethiopia, Kenya, Nigeria, and South Africa. Method: Both national and subnational data published from the year 2005 to 2015 were searched via MEDLINE, Scopus, and national public health websites. For each micronutrient and country, status data from relevant studies and surveys were combined into an average prevalence and weighted by sample size (WAVG). Inadequate intakes were estimated from mean (SD) intakes. Results: This review included 55 surveys and studies, 17 from Ethiopia, 11 from Kenya, 12 from Nigeria, and 16 from South Africa. The WAVG prevalence of anemia ranged from 25% to 53%, iron deficiency from 12% to 29%, vitamin A deficiency (VAD) from 14% to 42%, zinc deficiency from 32% to 63%, and iodine deficiency from 15% to 86% in children aged 0 to 19 years from 4 countries. Generally, children <5 years had higher prevalence of anemia (32%-63%), VAD (15%-35%), and zinc deficiency (35%-63%) compared to children aged 5 to 19 years. Studies with intake data indicated that inadequate intakes ranged from 51% to 99% for zinc, 13% to 100% for iron, and 1% to 100% for vitamin A. Households failing to consume adequately iodized (>15 ppm) salt ranged from 2% in Kenya to 96% in Ethiopia. Conclusion: With large variation within the 4 African countries, our data indicate that anemia and vitamin A, zinc, and iodine deficiencies are problems of public health significance. Effective public health strategies such as dietary diversification and food fortification are needed to improve micronutrient intake in both younger and older children.

Determinants of dietary diversity among pregnant women in Laikipia County, Kenya: a cross-sectional study

BackgroundDietary diversity has continued to gain widespread attention among the population since it has evidently been associated with nutrient adequacy. A diverse diet has been shown to reflect nutrient adequacy since no one food can meet the nutritional requirement of a person. Pregnant women have been considered vulnerable to malnutrition due to their increased nutrient requirement and therefore a variety of foods in their diet is considered imperative in ensuring adequate nutrient intake. To promote dietary diversity, it is important to understand the factors associated with it. This paper therefore assessed the determinants of dietary diversity among pregnant women in Laikipia County, Kenya.MethodsThe study was a cross-sectional analytical study consisting of 254 pregnant women attending antenatal clinic at Nanyuki Teaching and Referral Hospital in Laikipia County, Kenya.ResultsThe mean Dietary Diversity Score (DDS) was 6.84 ± 1.46 Standard Deviation (SD), with cereals being the most (99%) commonly consumed food group. Adjusted Logistic Regression (AOR) analyses revealed education level (AOR = 2.78; (95% Confidence Interval (CI) 1.06, 5.32; p < 0.001), employment status (AOR = 2.29; CI 1.18, 4.14; p = 0.003), monthly income (AOR = 2.08; CI 1.32, 3.03; p < 0.001), household assets (AOR = 1.93; CI 0.73, 6.90; p = 0.030), land ownership (AOR = 0.64; CI 0.44, 2.25; p = 0.040), and morbidity (AOR = 0.78; CI 0.36, 2.34; p = 0.010) among the pregnant women as the variables that influenced their dietary diversity.ConclusionSocioeconomic factors (education level, employment status, monthly income, household assets and land ownership) have been shown to influence dietary diversity in this study. New policies and intervention programmes targeting these determinants of dietary diversity should therefore be enacted, while the existing ones should be supported and monitored particularly among the vulnerable populations. Such policies and programmes among pregnant women will ensure improved dietary diversity and adequate nutrient intake. Similarly, since morbidity incidence among pregnant women have been shown to significantly influence dietary diversity, public health awareness campaign on the importance of early detection and timely treatment of diseases among pregnant women should be launched by the relevant stakeholders.

Influence of culture on dietary practices of children under five years among Maasai pastoralists in Kajiado, Kenya

Background and objectivesGlobally, children aged under five years are prone to malnutrition. Maasai are a nomadic community in Kenya still upholding traditional and has a high rate of child undernutrition. Consideration of cultural practices is a pre-condition for ensuring appropriate dietary practices. However, information on the influence of culture on dietary practices among Maasai children is minimal. The possible influence of culture on dietary practices among these children was investigated.MethodsSix focus group discussions sessions each consisting of 10 mothers were conducted from two randomly selected villages in Sajiloni location, Kajiado County.ResultsResults from this study showed that children mainly consume cereals and legumes. Nomadism makes animal products inaccessible to most children. Livestock are considered a sign of wealth, thus mainly slaughtered on special occasions. Additionally, selling of animals or animal products is not encouraged limiting income that would improve the food basket. Some food taboos prohibit consumption of wild animals, chicken and fish limits the household food diversity. Consumption of vegetables is limited since they are perceived to be livestock feed. The belief that land is only for grazing contributes to low crop production and consumption thus the diets lack diversification. Maasai culture encourages introduction of blood, animal’s milk and bitter herbs to infants below six months, which affects exclusive breast feeding. The men are prioritized in food serving leading to less and poor quality food to children. The consumption of raw meat, milk and blood is likely to lead to infections. The practice of milk fermentation improves bioavailability of micronutrients and food safety. Socialism ensures sharing of available food while believe in traditional medicine hinder visit to health facilities thus no access to nutrition education.ConclusionThis study concludes that culture influence the dietary practices among children under five years. It recommended initiation of programs to create awareness on how the beliefs negatively affect dietary practices with a view for a change.

Effects of Nutrition Education on Nutrition Knowledge and Iron Status in Primary School Pupils of Gatanga District, Muranga County, Kenya

School-age children are both growing and learning, and anaemia can affect cognitive function, motor performance and educational achievements of this age group. Nutrition education has not been given the priority it deserves in primary schools due to the busy school curriculum. It is in this light this study was designed for one teaching calendar year. Subjects & methods: Pupils (n=601) covering the age 11-18 years were included. The main objective of this study was to evaluate the effects of three main Nutrition Education strategies on nutrition knowledge and iron status among primary schools children in Gatanga district. A baseline survey was conducted in 12 randomly selected schools for class six pupils and their households. Questionnaires and an interview schedule were used to collect data, with pre and post tests. The interventions schools were Mabanda, Kigio and Kirwara (experimental) and Gakurari (control school). Baseline data were analyzed by use of Statistical Package for Social Sciences (SPSS) and Nutri-Survey computer packages using both descriptive and inferential statistics. The data were coded to search for emerging themes. This led to the identification of variables and concepts of iron deficiency in the children, which was crucial to the design of the corrective measures model for the interventions. On average the mean mark, in nutrition knowledge at baseline was 30.05%. In the post-tests all experimental schools (n=154) significantly improved in nutrition knowledge, and the peer facilitated school performed best with (51.52+24.79) marks, Researcher facilitated school (48.39+22.23) and the agriculture staff (38.70+9.87). The pre-test post- test improvement in the control school (31.21+12.74) was however not significant (p>0.05). A total of 31.4 % pupils ( Sub sample n=89) were found to be anaemic after altitude adjustments at a calculated factor 0.5 for Gatanga altitude (2237m ASL). Pupils’ haemoglobin status were not significantly different (p>0.05) between the experimental and control schools at baseline, notable differences occurred in the experimental schools after the interventions. Relationship between nutrition knowledge and nutrient intake was positive and there was a statistically significant relationship between nutrition knowledge and hemoglobin levels at p<0.05 (R 2 =0.253, p=0.025). Anemia was found to be a significant problem and therefore the need for a comprehensive intervention strategy by all stakeholders to improve the iron status in this age group.

Primary School Pupils in Kenya Learn and Practice Good Hygiene

Most health problems are directly or indirectly associated with environmental sanitation. Most illnesses could be associated with personal hygiene and sanitation of the pupils. Freund, Graybill, and Keith, 2005) in their study in Zambia reported that little was actually known about health of children from 6-15 years and much still remains to be learned. Research now shows that risk of poor health continues throughout childhood and childrens health status especially of girls, which actually worsens from age 5-15 years. Several studies have indicated a connection between hand sanitization and infection control in numerous settings such as extended care facilities, schools, and hospitals. Hand hygiene practices improve through increased frequency of hand washing and by increasing awareness of the importance of hand hygiene. This results in fewer Upper Respiratory Infection symptoms, lower illness rates, and lower absenteeism from school. Hand-hygiene interventions are efficacious for preventing gastrointestinal illnesses, in both developed and lesser-developed countries.

Enhancing Agricultural Production Potential Through Nutrition and Good Health Practice: The Case of Suba District in Kenya

Several studies have shown that HIV and nutrition operate in tandem. Moreover, it has been shown that the two greatly affect agricultural production due to reduced energy to work, inability to purchase agricultural inputs, low labor, and eventual death. The link between agricultural productivity, malnutrition, and HIV can therefore not be overlooked. People who are inadequately nourished are more susceptible to diseases and poor health. In an attempt to achieve optimal nutrition and good health among vulnerable groups, various intervention programs have used food supplementation and especially the plant-based food products to achieve this. Such programs have proved to be effective in restoring the nutrition and health status of the people. However, much more value would be achieved if such programs were complemented with basic health services such as deworming, water, sanitation, malaria control, hygiene. This chapter explores the benefits of research on nutrition as the basis for improving threatened rural communities’ nutria-health and potential economic performance. The premise is that good nutrition and preventive measures will reverse some of the human health problems associated with HIV, hunger, and/or malnutrition. Emphasis is placed on food preservation, processing, nutrition intervention, and education. Micronutrients through agronomic fortification/fertilization is recommended as an intervention with the benefit of improving the nutritive quality of food and thereby providing essential elements needed by the human body to combat malnutrition and poor health. The conclusion is that better nutrition will contribute to better health and increase productivity and production on the farm.