Background
Disease and lifestyle patterns have been changing rapidly especially in Africa due to transformation in economic development and urbanization. Research on the magnitude and consequences of these transformations in Africa is limited. This study investigates the shifts in nutritional status in children and adults in four selected low-, middle- and high-income countries in Africa, identifies factors associated with the shifts, and provides recommendations for future studies.
Methods
Malawi, Kenya, Ghana, and South Africa were selected based on their Gross Domestic Product (GDP). Nationally representative data were obtained from the 2017 Global Nutrition Report, Demographic Health Surveys (DHSs), and the World Health Organization (WHO) database. Prevalence of underweight, overweight, and obesity were assessed and compared across the countries, gender, residence, and over time. Results: South Africa had the highest GDP and largest prevalence of overweight and obesity rates in children < 5 years old and adults > 18 (13.3% and 51.9%, respectively). Malawi, with the lowest GDP, had the highest stunting rate (37.0%). In all 4 countries, but most notably in South Africa, trends indicated that the increasing prevalence of overweight and obesity was much greater than the declining rate of underweight. Malawi, Kenya, and Ghana had a slight decline in overweight prevalence in children under 5 years.
Conclusions
Nutritional shifts are occurring in Africa and seem to be heavily influenced by economic development. The double-burden of malnutrition presents prioritization challenges for policymakers. Attention needs to be shifted towards prevention of obesity, at least in the higher income countries in Africa.
Background: Malnutrition remains a major concern in the developing countries especially in food insecure populations. Maternal nutrition knowledge, among other factors, has been shown to improve nutritional status in children under the age of 5 years. The purpose of this study was to determine the effect of a nutrition education intervention on maternal nutrition knowledge, dietary intake, and nutritional status in Turkana County, Kenya.Methods: Seventy-three mothers/female caretakers with children <5 years old from Nadapal village in Turkana County were included in the study. At baseline, maternal nutritional knowledge, maternal and child nutritional status, and dietary intake were assessed. During the intervention, participants were trained on breastfeeding, complementary feeding, hygiene and sanitation. The intervention was conducted for five days with two- three hour sessions each day. Six months after the intervention, a follow-up was done to assess the effect of the intervention.Results: At baseline, 53% of the women were underweight (BMI<18.5 kg/m2), 24% of the children were stunted, 20.7% wasted, and 28.6% underweight. After the intervention, maternal knowledge on length of breastfeeding and composition of complementary foods improved. There were no significant changes in nutritional status in both women and children after the intervention.Conclusions: Results from this study implied that nutrition education interventions may improve nutrition knowledge of the mothers /female caretakers. However, without provision of food, the effects of the gained nutrition knowledge may not reflect in the dietary intake or nutritional status and therefore future interventions need to include ways to reduce food insecurity.
Refugees remain vulnerable to acute food insecurity, malnutrition, and critically inadequate food and nutrient intake after migration, regardless of the economic level of the host country. We conducted this systematic review to summarize and evaluate the dietary intake and nutritional status among refugees resettled in non-camp settings worldwide. We searched PubMed and Web of Science databases to review relevant studies published between 2009 and 2020 using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. We also conducted an additional manual search through PubMed and Google Scholar. Studies that evaluated both dietary intake and nutritional status of refugees in host countries were included. A total of 15 articles from 10 countries were included and assessed for study quality and outcomes. Poor dietary diversity and insufficient intake of specific food groups were reported. In addition to these dietary patterns, a high prevalence of stunting, underweight, and anemia was reported, particularly among children. A double burden of malnutrition was also observed across and within studies. Post-resettlement dietary intake and nutritional status of refugees are both influenced by factors at the pre- and post-resettlement stages as refugees transition to their host countries. Those factors including pre-resettlement experiences, host country resources, socioeconomic status, acculturation, and food security were summarized and presented in a conceptual model. There is a need for comprehensive dietary and health screening as well as culturally appropriate and sustainable nutrition education resources and interventions for refugees to improve their diet and nutrition. Longitudinal studies and novel methodological approaches are also suggested to measure changes in refugees’ food intake and nutritional status as well as to further investigate factors associated with these two components.
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