Department of Nutrition and Dietetics

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    Assessment Of Malnutrition In Patients Undergoing Chemotherapy At The National Oncology Centre Of The Korle-Bu Teaching Hospital, Accra, Ghana
    (African Health Sciences, 2023) Akpah, M.C.I.; Kegey, O.; Nortey, E.; et al.
    Background: Globally, cancer is on the rise, despite several interventions. The link between nutrition and cancer has long been established, with the consequences of poor nutrition on the cancer pathway being dire. Early nutrition intervention is recommended for all cancer patients. Objective: To assess malnutrition among patients undergoing chemotherapy at the National Radiotherapy Oncology and Nuclear Medicine Centre of the Korle-Bu Teaching Hospital (KBTH) in Accra, Ghana. Methods: A cross-sectional study was conducted among 123 patients with different types and stages of cancer who were undergoing chemotherapy. Data was collected from December 2018 to January 2019. The PG-SGA tool was used to assess weight loss at one and six months; food intake and nutrition impact symptoms. A correlation test was used to test the association between the PGSGA score and nutritional triaging. A T-test was used to determine the association between chemotherapy cycles and nutrition. A p-value <0.05 was considered to be significant. Results: The results revealed that 5.7% (n= 7) of the patients were well nourished, and 31.7% (n= 39) were suspected of being malnourished, and 62.6% (n = 77) were severely malnourished. About half of the participants (48%) had experienced weight loss ranging between 1 and 20 kg, with weight loss ≤5kg being most prevalent at both one and six months prior to the study. More than half (56.9%, n = 70) of the participants were consuming less than their usual intake. The majority of the participants had 4-6 nutritional symptoms (39.0%), with symptoms being mostly mild (39.1%). Poor nutritional status was positively correlated with nutritional symptoms (r = 0.747, p<0.001). Conclusion: The PGSGA tool identified that more than half of the patients were severely malnourished, hence the need for early nutrition intervention in cancer patients.
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    Validity of STRONGkids and MUAC as nutritional screening tools for predicting acute malnutrition among hospitalized children in Accra, Ghana
    (HSI Journal, 2023) Anku, E.K.; Adu- Amoah, H.G.; Ainuson-Quanpah, J.
    Background: Malnutrition is commonly reported among hospitalized paediatric patients. However, it is often not diagnosed leading to prolonged hospital stays and other medical complications. Objective: This study aimed at evaluating the validity of the Screening Tool for Risk of Nutritional Status and Growth (STRONGkids) and mid-upper arm circumference (MUAC) for assessing malnutrition in paediatric inpatients between the ages of 6 months and 5 years. The weight for-height (WFH) z-score was used as a reference standard for the evaluation. Methods: A cross-sectional study design was used in this study. A total of 96 individuals were enrolled in the study from both the Princess Marie Louise Children’s Hospital and Korle Bu Teaching Hospital, located in Accra, Ghana. Data were collected on demographics, admission details, weight, height, MUAC, and length of hospital stay. The STRONGkids screening tool was used for nutrition risk screening. Data analysis was performed using R version 4.1.0. Descriptive statistics were used to report frequencies, averages, percentages, standard deviations, and interquartile ranges. Diagnostic values were computed for STRONGkids and MUAC using WFH z-scores. Cohen's kappa was utilized to measure inter-rater agreement, with statistical significance set at p < 0.05. Results: Males accounted for 59.3% (n = 57/96) of the study sample. The prevalence of malnutrition in this study was 30% [n = 27/96; 95% confidence interval (CI): 21-39%]. The sensitivity and specificity of STRONGkids were 70% (95% CI: 52-86%) and 43% (95% CI: 31-55%), respectively. The sensitivity and specificity of MUAC were 45% (95% CI: 27-63%) and 93% (95% CI: 86-99%), respectively. The inter-rater agreement, based on two blinded assessments, for STRONGkids, was 0.57 (p = 0.006). Conclusion: The study revealed that STRONGkids had a low overall degree of validity, while MUAC had a high validity for specificity but lower validity for other diagnostic values. As a result, it is not recommended to use STRONGkids or MUAC individually for screening pediatric malnutrition in this setting, but rather in conjunction.
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    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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    Improving nutritional status of children with Cerebral palsy: a qualitative study of caregiver experiences and community‐based training in Ghana
    (Food Science and Nutrition, 2018-11) Donkor, C.M.; Lee, J.; Lelijveld, N.; Adams, M.; Baltussen, M.M.; Nyante, G.G.; Kerac, M.; Polack, S.; Zuurmond, M.
    Background Cerebral palsy (CP) is the most common childhood disability worldwide, and evidence shows that children with CP are at an increased risk of malnutrition due to feeding difficulties. This qualitative study explores caregiver experiences of feeding before and after a community‐based training program in Ghana. Methods Thirteen caregivers of children with CP, who were severely undernourished, were interviewed at the start of the training program. Eleven of these were interviewed again after a year of monthly group trainings and home visits, which included guidance on feeding. Four additional caregivers were interviewed at end line. Interviews explored caregivers’ mealtime experiences, as well as a 24‐hr dietary recall and a structured feeding observation checklist. Children's nutritional status was assessed by anthropometry. Results Caregivers found mealtimes stressful due to time demands, messiness, and the pressure of providing enough quality food. They felt that the training program had helped reduced this stress and dietary recall data suggested some improved dietary quality. However, there was neither improvement nor deterioration in anthropometric status of the children. Conclusion Group trainings were welcomed by caregivers and notably reduced stress around feeding times. However, future work is needed in order to improve anthropometric outcomes, including, but not limited to, greater focus on nutritional requirements during caregiver training interventions. Therapeutic feeding programs must also be better utilized and need to be better equipped to care for this group of children, including deviating from standard admission and treatment protocols.