Caregivers’ nutrition knowledge and attitudes are associated with household food diversity and children’s animal source food intake across different agro-ecological zones in Ghana

Abstract

Caregivers' nutrition knowledge and attitudes may influence the variety of foods available in the household and the quality of children's diets. To test the link, this study collected data on caregivers' (n 608) nutrition knowledge and feeding attitudes as well as the diets of their household and of their 2-5-year-old children in twelve rural communities nested in the three main agro-ecological zones of Ghana. Household foods and children's animal source foods (ASF) consumed in the past 7 d were categorised into one of fourteen and ten groups, respectively. About 28 % of caregivers believed that their children needed to be fed only 2-3 times/d. Reasons for having adult supervision during child meal times, feeding diverse foods, prioritising a child to receive ASF and the perceived child benefits of ASF differed across zones (P < 0·001). Households with caregivers belonging to the highest tertile of nutrition knowledge and attitude scores consumed more diverse diets compared with those of caregivers in the lowest tertile group (11·2 (SD 2·2) v. 10·0 (SD 2·4); P < 0·001). After controlling for the effect of agro-ecological zone, caregivers' nutrition knowledge and feeding attitudes positively predicted household dietary diversity and the frequency and diversity of children's ASF intakes (P < 0·001). The number of years of formal education of caregivers also positively predicted household dietary diversity and children's ASF diversity (P < 0·001). A key component to improving child nutrition is to understand the context-specific nutrition knowledge and feeding attitudes in order to identify relevant interventions.

Why are animal source foods rarely consumed by 6-23 months old children in rural communities of Northern Ethiopia? A qualitative study

“…Low nutritional knowledge was found to be a barrier for children's ASF consumption in the study area. A similar finding was also reported in Ghana, which demonstrated that caregivers' nutrition knowledge and feeding attitudes were significantly associated with both the household diet and the intake of ASFs by 2-5 years old children [32]. Nyantakyi-Frimpong et al, [30] Colecraft et al, [33] and Mukta et al, [34] also added that low ASFs consumption was due to the lack of information on the nutritional benefits of these foods.…”

EAACI position paper on diet diversity in pregnancy, infancy and childhood: Novel concepts and implications for studies in allergy and asthma

“…Diet diversity can be measured by counting individual foods, food groups or foods within a group, and can be measured over a time period ranging from the previous 24 hours (24‐hour recalls) or over a 7‐day period to intake over one year. Food intake data may be collected once or a number of times as summarized in Table a‐d.…”

“…Studies from both developed 29 and developing countries 30,31 have noted that an increase in diet diversity was associated with an increase in nutrient adequacy. Studies focusing on diet diversity have shown that an increase in diet diversity was associated with better growth indices in young children using height, weight, skin fold thickness and length for age or height for age z-scores to describe stunting, underweight and overweight, [32][33][34][35][36][37][38][39] though this might be confounded by socio-economic status. The association between diet diversity and other health outcomes in pregnancy, infancy and childhood (eg obesity) [40][41][42] has also been studied and is summarized in online supplementary Tables S1a-d.…”

“…There is a nonexhaustive list of factors that may affect allergy outcomes, but potential confounders should be corrected for analysing associations between diet diversity and allergy outcomes Diet diversity can be measured by counting individual foods, 31,37,[42][43][44][45][46] food groups 30,[34][35][36]38,39,41,43,[47][48][49][50][51][52][53][54] or foods within a group, 32,33,55,56 and can be measured over a time period ranging from the previous 24 hours (24-hour recalls) [31][32][33][34][35]38,40,44,46,48 or over a 7day period 33,39,42,47,53,[55][56][57] to intake over one year. Food intake data may be collected once [32][33][34]…”

Formative research to explore the acceptability and use of infant food grinders for the promotion of animal source foods and micronutrient powders in rural Peru

“…Globally, the delay of appropriate complementary foods is normative (Arabi, Frongillo, Avula, & Mangasaryan, 2012), and there is a body of literature on barriers to ASF and other nutrient-dense foods (Christian et al, 2016;Colecraft et al, 2006;Gittelsohn & Vastine, 2003;Hop, 2003;Pachón et al, 2007). One of the key barriers surrounds beliefs that the preparation of foods of a thicker consistency may cause problems of digestion, "heaviness" or stomach problems, swallowing, and choking (Black et al, 2013;Colecraft et al, 2006;Pachón et al, 2007;Pelto & Armar-Klemesu, 2011).…”