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Ugandan children are vulnerable to vitamin A deficiency (VAD), iron deficiency (ID) and zinc deficiency (ZnD) because they are fed on complementary foods (CFs) low in vitamin A, iron and zinc. This study developed a novel provitamin A carotenoid (PVAC), iron and zinc rich common bean pumpkin blend (BPB) complementary food (CF) from locally available pumpkin and common bean in Uganda and aimed to determine its acceptance, compared to a control pumpkin blend (PB). Seventy caregivers participated in the study. The sensory attributes (taste, colour, aroma, texture and general acceptability) of BPB and PB were rated using a five-point facial hedonic scale (1 = very bad, 2 = bad, 3 = neutral, 4 = good, 5 = very good). Focus group discussions (FGDs) were conducted to assess the perceptions of caregivers about the BPB. The chi square test was used to detect the proportion difference for each sensory attribute between BPB and PB, whilst FGD data were analysed by thematic analysis. A proportion of 64% to 96% of the caregivers rated both BPB and PB as acceptable (good to very good) for all the sensory attributes. There was no significant difference in caregiver acceptability for all attributes between BPB and PB (p > 0.05). Caregivers had positive perceptions about the taste, texture, aroma and colour of the BPB. Caregivers were keen to know the specific varieties of common bean and pumpkin used to formulate the PVAC, iron and zinc rich BPB. In conclusion, BPB was acceptable to caregivers, and they were interested to know how to prepare and use it as a CF.
The risk of child vitamin A deficiency (VAD) in low and middle income countries (LMICs) begins during the age range of complementary feeding (6-24 months), when children are fed complementary foods (CFs) deficient in vitamin A. However, pumpkin, a source of provitamin A carotenoids (PVACs) is widely cultivated in LMICs, but underutilized as a complementary food. Moreover, when consumed by humans, PVACs are bioconverted to retinol, the active form of vitamin A used by the body. This study evaluated the potential of pumpkin toward combating VAD by reviewing varieties of pumpkin cultivated in LMICs and their provitamin A carotenoid (PVAC) content; retention of PVACs in pumpkin during processing it as a CF; and the extent to which a CF prepared from pumpkin may meet the dietary reference intakes (DRIs) for vitamin A for children aged 6-24 months old. Pumpkin may combat VAD because the varieties cultivated have high b-carotene content, it is a provitamin A biofortifiable food crop, and 100% retention of PVACs was observed when processed using home cooking methods. Feeding less than 50 g of cooked pumpkin per day meets 100% of the recommended dietary allowance (RDA) and adequate intake (AI) of vitamin A for children 6 to 24 months old. Consumption of pumpkin may be used to complement vitamin A supplementation, fortification, and diversification of CFs with animal source foods. For better yield of pumpkin in LMICs, nutrition sensitive agricultural programmes such as biofortification and agronomic management of pumpkin need to be promoted and supported.
Background: Ugandan children are fed homemade complementary foods (CFs) which are usually deficient in vitamin A, iron and zinc. Novel homemade CFs rich in vitamin A, iron and zinc need to be developed, and assessed for their acceptability among target children. Objective: Homemade provitamin A carotenoids (PVACs), iron and zinc-rich complementary food (CF), common bean pumpkin blend (BPB) formulated from pumpkin (Sweet cream) and common bean (Obwelu) and PVAC-rich pumpkin blend (PB) from Sweet cream were prepared by expert peer mothers. This study compared child acceptability of BPB and PB (control). Methods: The crossover acceptability study randomly assigned Ugandan children 6 to 24 months old to either receive 100 g of BPB (n = 35) or 100 g of PB (n = 35) on day one. After a washout period of one day, children crossed over to receive either BPB (n = 35) or PB (n = 35). The amount of CF consumed, duration of consumption, and micronutrient intake were assessed. The CF was acceptable if children consumed ≥50 g (50%) of served food (100 g). A paired t-test was used to determine the mean differences within participants between BPB and PB. The level of statistical significant difference was set at a probability value of 5% (p = 0.05).
Background This study assessed staple food price volatility, household food consumption scores (FCS), poor household food consumption status and its association with socio-economic inequalities during enforcing and partial lifting of coronavirus disease-2019 (COVID-19) lockdown restrictions in slum and non-slum households (HHs) of Nansana municipality, Uganda. Methods Repeated cross-sectional surveys were conducted during enforcing and partial lifting of COVID-19 lockdown restrictions. A total of 205 slum and 200 non-slum HHs were selected for the study. Telephone based interviews with HH heads were used to collect data on socio-economic factors. Data for FCS was collected using the World Food Programme FCS method. Prices for staple foods were collected by face-to-face interviews with food vendors from the local market. Mean staple food price differences before COVID-19 lockdown, during enforcing, and partial lifting of lockdown was tested by Analysis of variance with repeated measures. Multivariate logistic regression analysis was used to assess the association between socio-economic variables and poor food consumption status. A statistical test was considered significant at p < 0.05. Results Mean staple food prices were significantly higher during enforcing COVID-19 total lockdown restrictions compared to either 1 week before lockdown or partial lifting of lockdown (p < 0.05). Mean FCS for staple cereals and legumes were significantly higher in slum HHs during COVID-19 lockdown compared to when the lockdown was partially lifted (p < 0.05). In slum HHs, the prevalence of poor food consumption status was significantly higher during partial lifting (55.1%) compared to total lockdown of COVID-19 (15.1%), p < 0.05. Among slum HHs during lockdown restrictions, food aid distribution was negatively associated with poor food consumption status (AOR: 0.4, 95% CI: 0.1–0.6), whilst being a daily wage earner was positively associated with poor food consumption status (AOR: 0.5, 95% CI: 0.1–0.6). During partial lifting of COVID-19 lockdown in slum HHs, poor food consumption status was positively associated with female headed HHs (AOR: 1.2, 95%CI: 1.1–1.6), daily wage earners (AOR: 3.2, 95% CI: 2.6–3.8), unemployment (AOR: 1.9, 95% CI: 1.5–2.1) and tenants (AOR: 2.4, 95% CI: 1.8–3.5). Female headed HHs, daily wage earners and tenants were positively associated with poor food consumption status either during enforcing or partial lifting of COVID-19 lockdown restrictions in non-slum HHs. Conclusion Staple food prices increased during enforcing either the COVID-19 lockdown or partial lifting of the lockdown compared to before the lockdown. During the lockdown, food consumption improved in slum HHs that received food aid compared to those slum HHs that did not receive it. Household heads who were females, daily wage earners, unemployed, and tenants were at risk of poor food consumption status either in slum or non-slum, and therefore needed some form of food assistance either during enforcing or partial lifting of the lockdown.
Between 1995 and 2016, the government of Uganda ratified several commitments to fight child undernutrition including achieving the 65 th World Health Assembly (WHA) targets of reducing stunting and wasting by 2025. It is important we monitor such commitments to inform policy makers about the progress of their commitments. The objective of this study was to review national and regional trends of stunting and wasting in Uganda from 1995 to 2016, and assess progress towards the 65 th WHA global nutrition targets for stunting and wasting. The Uganda Demographic and Health Surveys conducted from 1995 to 2016 were used to review national regional trends in stunting and wasting for children less than five years of age. At national level, the prevalence of wasting decreased from 5.3% in 1995 to 4.0% in 2016 while the prevalence of stunting decreased from 38.3% in 1995 to 29% in 2016. The annual reduction rate of stunting and wasting were 0.45% and 0.01% respectively. At regional level, the prevalence of wasting in Karamoja increased from 7.1% in 2011 to 10% in 2016, a similar trend of wasting was observed in west Nile (from 6.2 % in 2011 to 10.4 % in 2016), the prevalence of stunting (13.5% in 2011 to 18% in 2016) increased in Kampala region. In the year 2016, there was regional inequalities of stunting and wasting. Some regions were above or below the national prevalence. There was an overall decline of wasting and stunting in Uganda between 1995 and 2016, but the prevalence of stunting remained unacceptably high at 29%. By the year 2016, Uganda had already achieved the 65 th WHA target for wasting but may not achieve for stunting by 2025 if the annual reduction rate of stunting remains low at 0.45%. These findings summarize progress achieved towards fighting stunting and wasting in the last two decades in Uganda and help identify regions that need feasible interventions.
Background Ugandan children are fed homemade complementary foods (CFs) which are usually deficient in vitamin A, iron and zinc. Novel homemade CFs rich in vitamin A, iron and zinc need to be developed, and assessed for their acceptability among target children. Objective Homemade provitamin A carotenoids (PVACs), iron and zinc-rich complementary food (CF), common bean pumpkin blend (BPB) formulated from pumpkin (Sweet cream) and common bean (Obwelu) and PVAC-rich pumpkin blend (PB) from Sweet cream were prepared by expert peer mothers. This study compared child acceptability of BPB and PB (control). Methods The crossover acceptability study randomly assigned Ugandan children 6 to 24 months old to either receive 100 g of BPB (n=35) or 100 g of PB (n=35) on day one. After a washout period of one day, children crossed over to receive either BPB (n=35) or PB (n=35). The amount of CF consumed, duration of consumption, and micronutrient intake were assessed. The CF was acceptable if children consumed ≥ 50 g (50%) of served food (100 g). A paired t-test was used to determine the mean differences within participants between BPB and PB. The level of statistical significant difference was set at a probability value of 5% (p= 0.05). Results The mean consumption of BPB and PB was 53.9 g and 54.4 g, respectively. The mean duration for consumption of BPB and PB was 20.6 and 20.3 minutes, respectively. There was no significant difference in the amounts consumed, and duration of consumption in BPB and PB (p >0.05). The mean intake of vitamin A was significantly higher (p <0.00001) in PB (152.5 µgRAE) compared to BPB (100.9 µgRAE). The mean iron intake was significantly higher in BPB (1.1mg) (p <0.00001) compared to PB (0.3mg). Furthermore, zinc intake was significantly higher (p <0.00001) in BPB (0.58mg) compared to PB (0.13 mg). Conclusion A homemade complementary food, BPB, made from locally available common bean and pumpkin is rich in PVACs, iron and zinc and is acceptable to children in the age range of complementary feeding in Uganda.
Background Homemade complementary foods (CFs) fed to children in Uganda are usually devoid of vitamin A, iron and zinc. Novel homemade CFs rich in vitamin A, iron and zinc need to be developed, and assessed for their acceptability among target children. Objective Homemade provitamin A carotenoid (PVAC), iron and zinc-rich complementary food (CF), common bean pumpkin blend (BPB) formulated from pumpkin ( Sweet cream ) and common bean ( Obwelu ) and PVAC-rich pumpkin blend (PB) from Sweet cream were prepared by expert peer mothers. This study compared child acceptability of BPB and PB (control). Methods The cross-over acceptability study randomly assigned Ugandan children 6 to 24 months old to either receive 100g of BPB (n=35) or 100g of PB (n=35) on day one. After a washout period of one day, children crossed over to receive either BPB (n=35) or PB (n=35). The amount of CF consumed, duration of consumption, and micronutrient intake were assessed. CF was acceptable if children consumed ≥ 50g (50%) of served food (100g). A paired t-test was used to determine the mean differences within participants between BPB and PB. Results The mean consumption of BPB and PB was 53.9g and 54.4g, respectively. The mean duration for consumption of BPB and PB was 20.6 and 20.3 minutes, respectively. There was no significant difference in amounts consumed, and duration of consumption in BPB and PB (P>0.05). The mean intake of vitamin A was significantly higher (P<0.00001) in PB (152.5 µgRAE) compared to BPB (100.9 µgRAE). The mean iron intake was significantly higher in BPB (1.1mg) (P<0.00001) compared to BP (0.3mg). Furthermore, zinc intake was significantly higher (P<0.00001) in BPB (0.58mg) compared to BP (0.13mg). Conclusion A homemade CF, BPB, made from locally available common bean and pumpkin is rich in PVAC, iron and zinc and is acceptable to children in the age range of complementary feeding in Uganda.
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