NCT01111864.

No abstract

In our study population, consumption of yellow cassava led to modest gains in serum retinol concentration and a large increase in β-carotene concentration. It can be an efficacious, new approach to improve vitamin A status. This study was registered with clinicaltrials.gov as NCT01614483.

Hepcidin regulation by competing stimuli such as infection and iron deficiency has not been studied in infants and it’s yet unknown whether hepcidin regulatory pathways are fully functional in infants. In this cross-sectional study including 339 Kenyan infants aged 6.0±1.1 months (mean±SD), we assessed serum hepcidin-25, biomarkers of iron status and inflammation, and fecal calprotectin. Prevalence of inflammation, anemia, and iron deficiency was 31%, 71%, 26%, respectively. Geometric mean (±SD) serum hepcidin was 6.0 (±3.4) ng/mL, and was significantly lower in males than females. Inflammation (C-reactive protein and interleukin-6) and iron status (serum ferritin, zinc protoporphyrin and soluble transferrin receptor) were significant predictors of serum hepcidin, explaining nearly 60% of its variance. There were small, but significant differences in serum hepcidin comparing iron deficient anemic (IDA) infants without inflammation to iron-deficient anemic infants with inflammation (1.2 (±4.9) vs. 3.4 (±4.9) ng/mL; P<0.001). Fecal calprotectin correlated with blood/mucus in the stool but not with hepcidin. Similarly, the gut-linked cytokines IL-12 and IL-17 did not correlate with hepcidin. We conclude that hepcidin regulatory pathways are already functional in infancy, but serum hepcidin alone may not clearly discriminate between iron-deficient anemic infants with and without infection. We propose gender-specific reference values for serum hepcidin in iron-replete infants without inflammation.

BackgroundBiofortification of cassava with pro-vitamin A can potentially reduce vitamin A deficiency in low-income countries. However, little is known about consumer acceptance of this deep yellow variety of cassava compared to the commonly available white varieties. We aimed to determine the sensory and cultural acceptability of the consumption of pro-vitamin A rich cassava in order to identify key factors predicting the intention to consume pro-vitamin A rich cassava by families with school-aged children in Eastern Kenya.MethodsSensory acceptability was measured by replicated discrimination tests and paired preference tests among 30 children (7–12 yr) and 30 caretakers (18–45 yr) in three primary schools. Cultural acceptability was assessed with a questionnaire based on the combined model of The Theory of Planned Behavior and The Health Belief Model in one primary school among 140 caretakers of children aged 6 to 12 years. Correlations and multivariate analyses were used to determine associations between summed scores for model constructs.ResultsCaretakers and children perceived a significant difference in taste between white and pro-vitamin A rich cassava. Both preferred pro-vitamin A rich cassava over white cassava because of its soft texture, sweet taste and attractive color. Knowledge about pro-vitamin A rich cassava and it's relation to health (‘Knowledge’ ((β = 0.29, P = <.01)) was a strong predictor of ‘Health behavior identity’. Worries related to bitter taste and color (‘Perceived barriers 1’ (β = −0.21, P = .02)), the belief of the caretaker about having control to prepare cassava (‘Control beliefs’ (β = 0.18, P = .02)) and activities like information sessions about pro-vitamin A rich cassava and recommendations from health workers (‘Cues to action’(β = 0.51, P = <.01)) were the best predictors of intention to consume pro-vitamin A rich cassava.ConclusionsPro-vitamin A rich cassava is well accepted by school children in our study population.

Objectives: To examine the frequency of street food consumption of people living in low-income settlements in Nairobi and the role of street foods in their daily diet and to reveal why people consume street foods rather than home-prepared foods. Setting, subjects and methods: A cross-sectional descriptive study was done with 1011 households and in-depth interviews with a subsample of 73 households in two selected areas in Nairobi: Korogocho, a low-income slum area and Dandora, a low ± middle-income area. Results: The frequency of street food consumption was higher in Korogocho than in Dandora (3.6 vs 2.0 days per week; P`0.001). Street food consumption did not differ between different types of households, with the exception of household size. Employment status of the household head and street food consumption were related (P`0.001): consumption frequency of 3.7 days per week when irregularly or unemployed, 2.9 daysaweek when self-employed and 2.1 daysaweek when regularly employed. Furthermore, where an adult woman with primarily a domestic role was present, street food consumption was less (2.55 days per week when present vs 2.95 when not present; P`0.05). Conclusions: Street foods play an important role in the diet of poor households in Nairobi, in particular for breakfast and snacks, because they are cheap and convenient. The frequency of street food consumption is determined by a combination of at least four factors: level of household income; regularity of income; household size; and time available to prepare meals. Sponsorship: The project is ®nanced by the Netherlands Foundation for the Advancement of Tropical Research (WOTRO), ®lenumber WV 96-153.

Obesity is on the rise in developing countries, especially in urban areas. In this study, a cross-sectional study was conducted in two divisions in Nairobi province to determine the prevalence of and some risk factors associated with overweight and obesity among school children in Nairobi, Kenya. It involved 344 school children aged 9-14 years drawn from four randomly selected public and private primary schools. Weight and height were measured and body mass index was calculated. Nutrition status was determined using the World Health Organization age and gender specific BMI-for-age Z-scores (BAZ). The chi-square test was used to determine the relationship between overweight/obesity and selected socio-demographic characteristics. Complete anthropometric measurements were available for 321 children. Prevalence of combined overweight and obesity (BAZ > +1SD) was 19.0%, with prevalence being higher among girls (21.0%) than boys (16.9%) (p = 0.632). The prevalence among children in private schools was significantly higher (29.0%) than among those in public schools (11.5%) (p = 0.000). In addition, being a single child (p = 0.020), birth order (p = 0.017), mother’s occupation (p = 0.023) and type of residence (p = 0.028) were positively associated with overweight/obesity. The prevalence of overweight/obesity determined in this study is high and is a public health concern, with girls particularly at risk of becoming overweight.

This study examined whether street food vendors sell a sufficient variety of foods for a healthful diet. It was hypothesized that vendors sold only low-cost food groups to enable the buyer to afford the food while the vendor also made a profit. A structured questionnaire was administered to 580 vendors in three selected locations. Data included product names, ingredients, methods of preparation, and the sex of the vendor. A little more than half of the vendors (53%) sold food of only one group; 44% sold cereals. Overall, 36% of vendors, mostly men, sold only carbohydrate products. The percentage of vendors selling foods of more than one group was higher in the working area (53%) than in the slum area (43%, p < .05), and it was higher in both of these areas taken together than in the lower-middle income area (21%, p < .001). Micronutrient and mixed-nutrient products were associated with female vendors. Although a slight majority of all street vendors sell foods of only one group, women vendors are capable of supplying a sufficient variety of food groups that consumers can afford. It appears that consumer purchasing power dictates the food groups provided by vendors, especially cereal-based-foods. A policy on micronutrient fortification of cereal flours and fats used in popular street food preparation needs to be considered. This could be coupled with consumer and vendor education programs focusing on the importance of healthful diets.