Department of Nutrition and Dietetics
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Item Nutrition risk and validation of an HIV disease-specific nutrition screening tool in Ghana(South African Journal of Clinical Nutrition, 2019-07-25) Konlan, M.B.; Wright, L.; Boateng, L.; Epps, J.B.Objectives: The objectives of this study were to assess the nutritional status and the most commonly reported nutrition-related factors contributing to nutritional risk in people living with HIV/AIDS (PLWHA) in Ghana and the specificity and sensitivity of the Rapid Nutrition Screening for HIV disease tool (RNS-H) in this population. Design: A cross-sectional design was utilised. Patients were screened for nutritional status during a one-week period by clinic nurses using the RNS-H. Results were compared with a comprehensive nutritional assessment by a dietitian. Setting: The research was conducted in a public health clinic at the University of Ghana Hospital, Legon. Subjects Patients receiving care at the clinic were asked to participate. Outcome measures: The nutritional screening and nutritional assessment both resulted in participants being assigned to one of three nutritional statuses: ‘low risk’, ‘at risk’ and ‘high risk’. The association between the nutritional screening and nutritional assessment was measured. Results: The results of the nutritional status assigned by the RNS-H and nutritional assessment were compared. A total of 51 patients participated. A high prevalence of nutritional risk based on the RNS-S (54.9%) was found with 33.3% of the sample being malnourished. The most common nutrition-related complications were food insecurity, poor appetite, weight loss and diarrhoea. Conclusions: The RNS-H was found to have a strong specificity and sensitivity in a sample of Ghanaian PLWHA. Because of the nutritional risk and complexity of HIV in Ghana, nutritional screening using the RNS-H and nutrition care by a dietitian should be a standard of care.Item Nutritional counselling interactions between health workers and caregivers of children under two years: observations at selected child welfare clinics in Ghana(BMC Health Services Research, 2019-11-08) Intiful, F.D.; Nsiah-Asamoah, C.; Pereko, K.K.A.Background: This study evaluated the Health Works (HWs) nutritional counselling skills and information shared with caregivers. This was a cross-sectional study in which an observation checklist was used to examine Growth Monitoring and Promotion (GMP) activities and educational/counselling activities undertaken by health workers (HWs) to communicate nutrition information to caregivers, depending on the ages of the children. Methods: A total number of 528 counselling interactions between health workers and caregivers in 16 Child welfare Clinics (CWCs) in two rural districts in Ghana were observed. Frequencies were presented for the information that was obtained from each caregiver and those that were provided by the HWs during the nutritional counselling sessions. Results: About 95.1 and 61.8% of the caregiver-HW interactions involved mothers of children who were less than 6 months of age and those above 6 months respectively. HWs counselled the caregivers on appropriate nutrition for the child. Health talk messages that were shared with caregivers focused mainly on the importance of attending CWCs and vaccination of children and rarely included any teaching materials. In most of the interactions, HWs made of child’s feeding practices the past 1 month; and also did not provide advice on specific issues of IYCF. Nutritional counselling information given for non-breastfeeding children was inadequate and in some cases absent. Little attention was given to the feeding of children with animal products during counselling. Conclusion: Generally nutritional information given to caregivers who had children above 6 months was inadequate.Item Coconut oil and palm oil’s role in nutrition, health and national development: A review(Ghana Medical Journal, 2016-09) Boateng, L.; Ansong, R.; Owusu, W.B.; Steiner-Asiedu, M.Coconut and palm oils which were the major sources of dietary fats for centuries in most of West Africa have been branded as unhealthy highly saturated fats. Their consumption has been peddled to supposedly raise the level of blood cholesterol, thereby increasing the risk of coronary heart disease. This adverse view has led to a reduction in their consumption in West Africa and they have been substituted for imported vegetable oils. Recent information however, indicates some beneficial effects of these oils particularly their roles in nutrition, health and national development. There is the need for a better understanding of their effects on health, nutritional status and national development. This paper therefore attempts to review the roles which coconut and palm oils play in these respects in developing countries, as a means of advocating for a return to their use in local diets.Item Weight loss practices among newly enrolling clients in a commercial weight loss program in Ghana(2016-03) Ayisi-Addo, S.; Ayisi-Addo, S.; Ohemeng, A.Background: In Ghana, obesity is showing a rising trend and there are weight loss initiatives being practised by individuals. However, the levels of commitment to such programs and the reasons for discontinuing have not been assessed. The objectives of this study were to investigate the weight loss practices of participants and reasons for quitting chosen weight loss programs. Methods: This was a cross-sectional study involving 50 subjects conveniently selected from people who were enrolling into a commercial weight loss program. A questionnaire was used to collect data on past weight loss practices and reasons for abandoning chosen programs. Data analysis was conducted using simple frequency and descriptive tests of the Excel software. Results: More than half of the subjects (66%) had undertaken a weight loss practice before enrolment in study. Of these, 88.5% abandoned the strategy before the achievement of their desired weight goal. The three common programs that were practised were internet based diets (67.9%), commercial weight loss shakes (42.9%) and exercises (28.6%). Reasons given for abandoning programs included lack of sustainability (50%), lack of determination on the part of the client (15%), boredom with program (10%), not achieving desired results (10%), safety concerns (10%), and getting pregnant (5%). Conclusions: The findings suggest that future weight loss programs can be effective and have reduced attrition rates if they are designed to achieve sustainable dietary and other lifestyle changes, as well as boost motivation for weight loss.Item Prevalence of Childhood Overweight/Obesity in Basic School in Accra(Ghana medical journal, 2012-09) Mohammed, H.; Vuvor, F.Background: This study intends to determine the prevalence of obesity among children in the University Primary School, Legon. It also intends to determine relationship between the prevalence of obesity in children and socio-economic status of their parents and the most endemic age group. Method: The study was conducted using 270 students sampled at random in the basic school. Children’s height, weight and skin fold measurement were taken. Children’s parent’s socio-economic status was assessed using close and open-ended questionnaires administered to parents. Data obtained was then analyzed using SPSS software. Results: Prevalence of obesity in the university primary school was found to be 10.9% with higher prevalence in girls (15.0%) than in boys (7.2%) (Pvalue= 0.001). There was higher prevalence among children from high socioeconomic background (21 – 23%) with least prevalence in those from low socioeconomic homes (10 – 20%) though this was not significant (p-value=0.23). Girls showed a higher body fat composition between 10 –12years, whiles boys showed higher body fat stores between 8 – 10 years old. Increasing mother educational level reduced prevalence of child obesity (p-value=0.043) but this was not seen in increasing fathers’ educational level (pvalue= 0.261). Conclusions: The prevalence of obesity in children in University primary school was very high and worrying. The prevalence increased with socio-economic status and it is more common in females than males. It was recommended that similar study should be expanded nationwide.Item Dietary intake as a cardiovascular risk factor: a cross-sectional study of bank employees in Accra(South African Journal of Clinical Nutrition, 2018-10) Frimpong, I.P.; Asante, M.; Maduforo, A.N.Objectives: To determine the dietary and nutrient intakes of bank employees in Accra in relation to recommended dietary intake for the control of cardiovascular diseases (CVD). Design: The study was a cross-sectional study. Methodology: A structured validated questionnaire was used to obtain demographics. A 3-day 24-hour dietary recall and usual food intake questionnaire were used to obtain information on food intakes and dietary pattern of the respondents. Food models, household measures and photos of common dishes as well as household cups and measures were used in order to obtain accurate information regarding the types and quantities of foods and beverages consumed. Subjects: Convenient sampling was used to select bank branches while simple random sampling by ballot without replacement was used to select 119 bank employees who consented to participate in the study. Outcome measures: Data were analysed using Statistical Package for the Social Sciences software. Esha FPro software was used to analyse food nutrients. The nutrient intakes were compared with a standard dietary guideline for adults. Results: Findings showed significant (p < 0.05) differences in mean energy intake between males and females. Also, the bank employees were consuming more fat (32%) compared with the recommended intake. The average intake of dietary sodium and cholesterol was within the recommended intake levels. All the participants in the study had a mean intake of dietary potassium, fibre, fruits and vegetables below the recommended levels. The major cooking oils used in meal preparation were vegetable and palm oil (46%), followed by vegetable oil (31.9%) and palm oil (21.8%). Conclusions: The study evaluated the dietary intake of bank employees, which is an important risk factor for chronic diseases. There is a need to develop plans to provide nutrition education and counselling for adequate nutrient intake and prevention of chronic diseases among bank employees. Layman's summary: Obtaining an adequate diet and avoiding overconsumption of food helps to maintain health. Intake of foods containing high energy and fats without corresponding energy expenditure through physical activity could result in obesity, heart diseases, diabetes and other health challenges. Inadequate intake of micronutrients as well could result in deficiency diseases, and depresses the immune system and health of individuals. Bank employees and all other individuals need to pay attention to what they eat to live a healthy and longer life. Regular physical activity, following the dietary approaches to avoid hypertension and regular medical check-up are essential for cardiovascular health. Strong lay message: Inadequate or overconsumption of nutrients can cause chronic heart diseases.Item Phytochemical Properties and Nutrigenomic Implications of Yacon as a Potential Source of Prebiotic: Current Evidence and Future Directions(Foods, 2018-04) Cao, Y.; Ma, Z.F.; Zhang, H.; Jin, Y.; Zhang, Y.; Hayford, F.The human gut is densely populated with diverse microbial communities that are essential to health. Prebiotics and fiber have been shown to possess the ability to modulate the gut microbiota. One of the plants being considered as a potential source of prebiotic is yacon. Yacon is an underutilized plant consumed as a traditional root-based fruit in South America. Yacon mainly contains fructooligosaccharides (FOS) and inulin. Therefore, it has bifidogenic benefits for gut health, because FOS are not easily broken down by digestive enzymes. Bioactive chemical compounds and extracts isolated from yacon have been studied for their various nutrigenomic properties, including as a prebiotic for intestinal health and their antimicrobial and antioxidant effects. This article reviewed scientific studies regarding the bioactive chemical compounds and nutrigenomic properties of extracts and isolated compounds from yacon. These findings may help in further research to investigate yacon-based nutritional products. Yacon can be considered a potential prebiotic source and a novel functional food. However, more detailed epidemiological, animal, and human clinical studies, particularly mechanism-based and phytopharmacological studies, are lacking for the development of evidence-based functional food products.Item Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017(The Lancet, 2018-11) Murray, C.J.L.; Callender, C.S.K.H.; Kulikoff, X.R.; Srinivasan, V.; Abate, D.; Abate, K.H.; Abay, S.M.; Abbasi, N.; Abbastabar, H.; Abdela, J.et.al.BACKGROUND: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. METHODS: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10-54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10-14 years and 50-54 years was estimated from data on fertility in women aged 15-19 years and 45-49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. FINDINGS: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4-52·0). The TFR decreased from 4·7 livebirths (4·5-4·9) to 2·4 livebirths (2·2-2·5), and the ASFR of mothers aged 10-19 years decreased from 37 livebirths (34-40) to 22 livebirths (19-24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3-200·8) since 1950, from 2·6 billion (2·5-2·6) to 7·6 billion (7·4-7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15-64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9-1·2) in Cyprus to a high of 7·1 livebirths (6·8-7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07-0·09) in South Korea to 2·4 livebirths (2·2-2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3-0·4) in Puerto Rico to a high of 3·1 livebirths (3·0-3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. INTERPRETATION: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. FUNDING: Bill & Melinda Gates Foundation.Item A pilot study comparing bioelectrical impedance analysis and body mass index in determining obesity among staff of a Ghanaian University(Nutrition and Food Science, 2018-10) Hayford, F.E.A.; Appiah, C.A.; Al Hassan, T.; Asamoah-Boakye, O.; Asante, M.Purpose In Ghana, the body mass index (BMI) is widely used in clinical practice in assessing weight status, but it is limited as a measure of adiposity. The purpose of this study was to compare bioelectrical impedance analysis (BIA) and body mass index (BMI) methods in determining obesity among some Ghanaians. Design/methodology/approach This was a cross-sectional survey involving 134 participants whose BMI were determined. Percentage body fat mass (%BF) and percentage visceral fat (%VF) were obtained by BIA using a hand-to-hand Omron body composition monitor with a weighing scale. Findings Based on the WHO BMI criteria, 6.0 per cent of the participants were obese. However, according to BIA 18.7 and 20.9 per cent of the participants were obese according to % BF and %VF, respectively. The BMI and %BF showed higher prevalence of obesity among female participants (8.2 and 34.4 per cent, respectively) than male participants (4.1 and 5.5 per cent, respectively), whereas for %VF, obesity was higher among male participants than female participants (26.0 per cent, 14.8 per cent). There was significant positive correlation between BMI and % BF (r = 0.604, p = 0.001); and between BMI and %VF (r = 0.555, p = 0.001). Research limitations/implications There are discrepancies in the prevalence of obesity in the study population as measured by BMI and BIA methods. This suggests that the BMI and BIA may not be reliable tools for assessing obesity in this population. Further studies are needed to determine the cut-offs for BMI and BIA that are associated with metabolic risk in the population. The small sample size limits the generalizability of findings of this study. Originality/value Body composition tends to vary by ethnicity and race; hence, it is essential to determine the appropriate tool for assessing adiposity in African populations for prompt and targeted interventions.Item Sensory attributes and acceptability of complementary foods fortified with Moringa oleifera leaf powder(Nutrition and Food Science, 2018-10) Boateng, L.; Nortey, E.; Ohemeng, A.N.; Asante, M.; Steiner-Asiedu, M.Purpose Inadequacies in several micronutrients in complementary foods, notably iron, zinc, calcium, vitamin A, vitamin B6 and riboflavin have been reported. Moringa oleifera leaf powder (MLP), prepared from dried moringa leaves is nutrient-rich and has been explored for the treatment of micronutrient deficiencies among children in developing countries. This increasing interest in the use of moringa oleifera leaves to improve complementary foods notwithstanding, the unique sensory characteristics of the leaf powder potentially holds implications for the acceptability of local diets that are fortified with it. The purpose of this paper is to investigate the levels of MLP fortification that are most acceptable for feeding infants and young children. Design/methodology/approach The authors performed a review of the literature, with the aim of investigating the sensory attributes and acceptable levels of fortification of complementary food blends fortified with different levels of MLP. Findings The minimum amount of MLP to be added to a complementary food blend to observe significant improvements in its nutritional value was estimated to be about 10 per cent. However, at this 10 per cent fortification level also, sensory attributes of the products begin to become less desirable. Practical implications For the success of nutrition interventions that involve the use of MLP to improve the nutritional quality of complementary foods, there is a need to consider the acceptability of the sensory attributes of the formulated blends in the target group. Safety of MLP as an ingredient in infant foods must also be investigated. Originality/value The authors of this paper make recommendations for the use of MLP to fortify complementary foods to ensure its success as a food fortificant in nutrition interventions. The researchers are not aware of any published study that focuses on this subject.
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