Nutritional Knowledge, Attitudes, and Practices of Women Living with HIV in Eastern Uganda

HIV and AIDS have posed various medical, nutritional, social and economic problems, female-headed households being the most affected. Poor nutritional knowledge and dietary practices common among the most affected households significantly contribute to the rapid progression of HIV. However, very little data exist concerning these aspects of nutrition among women living with HIV and AIDS in resource-limited settings, such as Uganda. The aim of the study was to investigate the gaps in nutritional knowledge, attitudes, and practices and their relationship with sociodemographic characteristics in an urban population of women living with HIV and AIDS in Uganda. In total, 133 women living with HIV were interviewed using a pretested questionnaire. Most (89.5%) women reported being trained on the importance of nutrition for people living with HIV and AIDS (PLWHA) and believed that it is very important to consume a balanced diet (99.5%). On the contrary, only 21.8% consumed at least three meals per day and 39.8% at least six food-groups. They also reported higher dependency on starchy staples while foods of animal origin and fruits that play vital immunity and protective roles were inadequately consumed. Results of bivariate analysis indicated that consumption of a diversified diet was significantly associated with access to food-aid (p=0.006), possibly because access to food-aid reportedly enhances the ability of the household to access other food items. However, much is still needed to understand the drug-food interaction and dietary diversification and enhance proper dietary practices through sustainable projects that ensure increased access to food. Support groups of the PLWHA are a good vehicle for communication of nutrition information and implementation of nutrition-related projects.Key words: Acquired immunodeficiency syndrome, Cross-sectional studies, Diet, Human immunodeficiency virus, Knowledge, attitudes, practices, Nutrition, Uganda     

Food allergies in children affect nutrient intake and growth

OBJECTIVES: To identify if specific food allergies, elimination diets, or other variables associated with food allergies have an impact on the growth and nutrient intake of children with food allergies. DESIGN: Measurements of height, weight, and body mass index were used to determine potential growth problems. Estimates of energy and nutrient intakes were based on 3-day diet records. A questionnaire was used to determine number of food allergies and other variables. SUBJECTS: Ninety-eight children with food allergies (subjects, mean age 3.7 +/- 2.3 years) and 99 children without food allergies (controls, mean age 4.1 +/- 2.4 years) participated in this age-matched, consecutive sampling, cross-sectional study. STATISTICAL ANALYSIS PERFORMED: Cochran-Mantel-Haenszel statistics using general association and Fisher Exact Test, with 2-sided probability, were conducted. RESULTS: Children with two or more food allergies were shorter, based on height-for-age percentiles, than those with one food allergy (P<.05). More than 25% of children in both groups consumed less than 67% of the DRI (RDA or AI) for calcium, vitamin D, and vitamin E. More children with cow's milk allergy or multiple food allergies consumed dietary calcium less than age- and gender-specific recommendations compared with children without cow's milk allergy and/or one food allergy. The possibility of consuming a less than recommended intake of calcium and vitamin D in children with food allergy was less if the child received nutrition counseling (P<.05) or consumed a safe infant/toddler formula or fortified soy beverage. APPLICATIONS/CONCLUSIONS: Children diagnosed with food allergies need an annual nutrition assessment to prevent growth problems or inadequate nutrient intake. Children with milk allergies or multiple food allergies are at greater risk. Nutrition education needs to address how to avoid all forms of the allergen and incorporate alternative nutrient-dense foods. This population would benefit from the development and validation of a medical nutrition therapy protocol.     

The Relationship of Body Size to Participation and Success in a Fruits and Vegetables Intervention among Low-income Women

We examined participation and dietary change among women participants in a community-based nutrition education program, to determine whether intervention results differed by participant body size. Four dietary indicators (daily servings of fruits and vegetables, total calories, calories from fat, and Healthy Eating Index score) were assessed from 24-h recalls taken before, immediately after, and 4 months after a seven-session nutritional education program, from 156 African-American women age 20–50, in Washington, D.C. public housing. Knowledge, attitudes and practices related to nutritional behavior change were collected at three timepoints as well. Random effect models were used to examine dietary patterns, and compare change by body size and class attendance. Results showed that obese women (BMI ≥ 30) had more psychosocial barriers to dietary change and poorer baseline diets, but stronger program attendance. Post-intervention, both groups consumed approximately 250 fewer calories and 2.5% fewer calories from fat. At follow-up, non-obese women consumed significantly fewer calories; obese women consumed significantly fewer calories from fat, and showed significant improvement in HEI. Given the prevalence of obesity in low resource communities, nutritional interventions should tailor strategies to participant body size and related psychosocial needs.     

Dietary Risk Factors for Cardiovascular Disease among Low-Income Haitian Adults: Findings from a Population-Based Cohort

Poor diets are responsible for a large burden of noncommunicable disease (NCD). The prevalence of modifiable dietary risk factors is rising in lower-income countries such as Haiti, along with increasing urbanization and shifts to diets high in sugar, salt, and fat. We describe self-reported dietary patterns (intake of fruits, vegetables, fried food, sugar-sweetened beverages, and added salt and oil) among a population-based cohort of low-income adults in Port-au-Prince and assess for associated sociodemographic factors (age, sex, income, education, body mass index). Among 2989 participants, the median age was 40 years, and 58.0% were women. Less than 1% met the World Health Organization recommendation of at least five servings/day of fruits and vegetables. Participants consumed fried food on average 1.6 days/week and sugar-sweetened beverages on average 4.7 days/week; young males of low socioeconomic status were the most likely to consume these dietary risk factors. The vast majority of participants reported usually or often consuming salt (87.1%) and oil (86.5%) added to their meals eaten at home. Our findings underscore the need for public health campaigns, particularly those targeting young males and household cooks preparing family meals at home, to improve dietary patterns in Haiti in order to address the growing NCD burden.     

Culturally relevant nutrition education improves dietary quality among WIC-eligible Vietnamese immigrants

OBJECTIVE: To provide culturally appropriate nutrition education to improve the diets of Vietnamese women. DESIGN: A total of 152 homemakers were recruited to participate in a nutrition education project, with 76 receiving the intervention and 76 serving as the control group. SUBJECTS/SETTING: Non-English-speaking women eligible for the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) with incomes below 185% of the poverty level living in 5 California counties. INTERVENTION: Bicultural, bilingual Vietnamese-American nutrition education assistants taught 5 to 7 lessons in the Vietnamese language using nutrition education materials written in the Vietnamese language by 2 bilingual, bicultural nutritionists. MAIN OUTCOME MEASURES: Twenty-four-hour food recalls were obtained before and after the 8-week interval on the treatment and control groups. STATISTICAL ANALYSIS: To examine if there were changes over time in nutrient intake and nutrient density within groups, matched pair t tests were done. Analysis of covariance techniques determined differences between groups. McNemar tests determined if, within groups, there were changes over time in food groups consumed. Chi-square techniques determined changes between groups. RESULTS: Over time, the number of treatment group participants who had at least one serving from each food group (P <.01), and who had the recommended number of servings from each food group (P <.05), significantly increased in comparison to the control group. Over time, the dietary nutrient density of calcium, riboflavin, and vitamin B6 (P <.05), as well as potassium (P <.01), of treatment group participants significantly improved in comparison to the control group. IMPLICATIONS: With training, bilingual, bicultural women can effectively deliver culturally relevant nutrition education to their peers.     

Effect of nutrition education on the nutritional status of low-income pregnant women of Mexican descent.

Low-income pregnant women of Mexican descent were studied to determine whether their food habits could be improved by nutrition education. Biochemical indices of nutritional status were also investigated. Twenty-four-hour dietary recalls were obtained at an initial interview and again at a final interview after a nutrition education program, which was offered to a randomly selected treatment group. At the initial interview, the mean nutrient intakes that were most often below two-thirds of the Recommended Dietary Allowance (RDA) were iron, vitamin A, thiamin, and calcium. The mean energy value of the diets was also frequently below the RDA. At the final intakes, although the mean energy values and the calcium and carbohydrate of both the control and treatment groups increased significantly, the following improvements in dietary intakes were seen only within the treatment group: 1) there were significant increases in the mean intake of protein, ascorbic acid, niacin, riboflavin, and thiamin, 2) there were significant decreases in the percentage of intakes below two-thirds of the RDA for ascorbic acid and riboflavin, and 3) there was a significant decrease in the incidence of multiple low nutrient intakes. These dietary improvements, which occurred only in the treatment group, suggest the effectiveness of the nutrition education program. The most common biochemical deficiencies were of folic acid, thiamin, and riboflavin. Except for an improvement in mean serum folate levels, the biochemical indices for the treatment group did not appear to be influenced by the nutrition education. It is possible that the vitamin and mineral supplements which were taken by 80% of the women could have obscured improvements in biochemical indices which may have been due to the education program.     

Nutritional status of infants and young children and characteristics of their diets

Adoption of the recommended breast-feeding and complementary feeding behaviors and access to the appropriate quality and quantity of foods are essential components of optimal nutrition for infants and young children between ages 6 and 24 mo. Iron, zinc and vitamin B-6 are deficient in complementary food diets in Bangladesh, Ghana, Guatemala, Mexico and Peru. Low intakes of iron are consistent with a high prevalence of anemia seen in this age group. The adequacy of observed intakes for calcium, vitamin A, thiamin, folate and vitamin C depends on the age range in question and the set of requirements used in the assessment. The lipid content of many complementary food diets is low. In addition to providing essential fatty acids, lipids are needed for the absorption of fat-soluble vitamins and also enhance the texture, flavor and aroma of foods, which may lead to increased intake. The relative roles of palatability, micronutrient deficiency and morbidity-induced anorexia in the appetite of infants and young children are not known. However, even among children who were growth retarded and had a total energy deficit compared with requirements, up to 25% of food offered was not consumed. This indicates that dietary quality rather than quantity is the key aspect of complementary food diets that needs to be improved. Targeted fortification or the production of complementary foods fortified with micronutrients and of an adequate macro- and micronutrient composition is one approach to help meet nutritional requirements during the vulnerable period of 6-24 mo.     

Dietary intakes of Title III meal program recipients and nonrecipients

Nutrient intakes, dietary habits, and the nutrition knowledge and attitudes of elderly recipients and nonrecipients of a Title III meal program were examined. Mean intakes of energy and all nutrients except niacin and vitamin C were higher for recipients, although no statistically significant differences were found. High average intakes of protein, iron, vitamin A, riboflavin, niacin, and vitamin C were shown among all groups. Low individual intakes were found for energy, calcium, vitamin A, and thiamin. Men consumed significantly more protein, fat, and riboflavin than women. As age increased, intakes of fat, protein, iron, thiamin, and niacin decreased. More than 75% of all subjects had diets rated "fair" or "good." Percentages of kilocalories from protein were above the recommended levels for all groups, and percentages of kilocalories from fat were above recommended levels for all groups except recipient women. Neither the number of meals eaten alone nor living arrangements had a significant effect on the patterns of intake of the nutrients studied. Most of the subjects interviewed did not regularly take vitamin/mineral supplements. Of those who took supplements, most consumed adequate diets. No significant differences were found in the nutrition knowledge or attitudes of recipients and nonrecipients, although recipients had slightly higher scores. Nutrition knowledge scores were above 60% for all groups. Educational attainment was positively correlated with nutrition knowledge.     

Identification and characterization of traditional diets from Burundi by multivariate analysis

Multivariate analyses were applied to food habits in Burundi in order to identify typical food combinations and to determine the extent to which these patterns are compatible with nutritional adequacy and diversity. Eight criteria were used in cluster analysis: food intake (g/pers/day), energy intake, protein, lipid, carbohydrates, calcium, iron and vitamin C intakes. Macronutrients expressed as a percentage of total energy intake were also taken into account in order to differentiate diets on a qualitative basis. Six clusters, each containing 5 to 12 meals, were identified as the most representative of Burundian diets in rural areas. These meal clusters were discriminated by their calcium, energy, protein and iron contents. In comparison with nutritional guidelines, most of them failed to meet the recommendations. The results obtained may be beneficial to nutrition educators and policy makers in targeting food programs and education efforts to improve diet adequacy.     

Racial differences in dietary choices and their relationship to inflammatory potential in childbearing age women at risk for exposure to COVID-19

Since the ongoing coronavirus disease 2019 (COVID-19) pandemic is linked to chronic inflammation, people with initial lower inflammatory status could have better outcomes from exposure to this disease. Because dietary habits are one of the most important modifiable risk factors for inflammation, identification of dietary components associated with inflammation could play a significant role in controlling or reducing the risk of COVID-19. We investigated the inflammatory potential of diets consumed by African American (AA) and Caucasian American (CA) women of childbearing age (n = 509) who are at high risk for exposure to COVID-19 by being residents of Birmingham, Alabama, a city severely affected by this pandemic. The overall pro- and anti- inflammatory scores were calculated using dietary intake data gathered using Block food frequency questionnaire. The proinflammatory potential of diets consumed by AAs was significantly higher compared to CAs. Several anti- and proinflammatory nutrients and food groups consumed differed by race. With consumption of a greater number of antioxidants and B-vitamins, CAs switched toward an anti-inflammatory score more effectively than AAs while AAs performed better than CAs in improving the anti-inflammatory score with the consumption of a greater number of minerals and vitamin D. Effective race-specific dietary modifications or supplementation with nutrients identified will be useful to improve proinflammatory diets toward anti-inflammatory. This approach could aid in controlling the current COVID-19 pandemic and future pandemics of a similar nature in women at risk for exposure.     

海口市550名医学生膳食营养状况

目的了解海口市医学生膳食营养状况,为改善学生膳食质量提供指导意见。方法采用24h膳食回顾法,记录550名医学生连续5d的膳食情况,利用营养计算器V6.0版及Excel软件对结果进行分析。结果大多数学生能量、维生素A、维生素C、钙等营养素摄入量不足,男生膳食维生素A、维生素C、钙的摄入量分别为推荐摄入量的63.63%,50.00%及44.63%,女生分别为61.00%,50.00%和44.13%,女生能量摄入量为推荐摄入量的81.60%。膳食钙磷比男、女生分别为0.31和0.40。早、中、晚三餐能量分配分别为18%,43%和39%。结论海口市医学生膳食结构不够合理,应增加能量、维生素A、维生素C、钙的摄入量。     

Supplementenkonsum bei Jugendlichen in Deutschland

In 2006, 20 % of adolescents aged 12-17 years used dietary supplements. Persons with high physical activity levels as well as those with high education levels consumed dietary supplements more often than others. Many supplement users used only one single-nutrient supplement. A similarly large proportion of users consumed one supplement with multiple nutrients. Most often supplements containing vitamin C, magnesium, B-vitamins, vitamin E and calcium were used.     

哈尔滨市孕妇营养调查

本文于1982年3月至10月对哈尔滨市各区来院检查的孕妇进行了营养和贫血调查。 调查结果表明,孕妇的膳食组成是合理的,热能和主要营养素能满足需要。但是,钙、维生素A、胡萝卜素、核黄素和抗坏血酸是不足的,只能满足孕妇需要量的30～60％。铁虽然数量充足,但因来源于谷类和植物,缺少肉类和抗坏血酸,孕妇贫血的发生率较高,妊娠末期为26,0％,春季贫血为36.3％、夏季贫血为18.3％。 根据存在的问题,我们提出了孕妇食品和营养素供给量的建议,以保证广大孕妇的健康和胎儿的优生。     

Gender and age group differences in nutrition intake and dietary quality of Korean adults eating alone: based on Korean National Health and Nutrition Examination Survey Data, 2013–2016

BACKGROUND/OBJECTIVESThis study investigated gender and age differences in nutrient intake and dietary quality of people eating alone.SUBJECTS/METHODSFrom Korean National Health and Nutrition Examination Survey 2013–2016 data, 2,305 adults aged 20 years and older that ate meals alone were included in this study. Their energy and nutrients intakes, as well as their nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ) were analyzed. Food group consumption pattern, dietary variety score (DVS), dietary diversity score (DDS) were also analyzed. All data were compared among gender and age groups.RESULTSMen consumed more energy and nutrients than women, except for vitamin C, and the NARs showed similar gender differences. The INQs of 4 nutrients (calcium, vitamin A, vitamin C, and riboflavin) were lower than 1.0 in men, whereas only the calcium INQ was lower than 1.0 in women. Men had a lower DDS (3.6) than women (3.9) (P < 0.001) and had more ‘undesirable’ food group consumption patterns than women (P < 0.001). The intakes of calcium, vitamin A, and vitamin C were relatively low in the young-aged group (INQs less than 1.0). In the old-aged group, the MAR level was relatively low, and the INQs of calcium, riboflavin, and niacin were below 1.0. The old-aged group consumed more menu items, but their DVS was the lowest.CONCLUSIONSCompared to women, the dietary quality and food diversity among men were poorer. There were poorer quality and diversity patterns in the young-aged group compared to those of the older groups. An overall low intake of nutrients and the low nutrient density of meals were the main dietary problems among the old-aged group who eat alone. Therefore, men, particularly young- and old-aged, need to be prioritized in nutritional policies directed toward those who eat alone.     

Nutrient Intake of Urban Elderly American Indians

To provide nutrition programming for the local American Indian Council preliminary food intake data was collected. Twenty urban elderly American Indians consented to provide three day dietary records and seventeen provided demographic information. Additionally, twenty elderly non-American Indians provided dietary records for comparison purposes. Results of the nutrient analysis indicated nutrient intakes similar to the general elderly population with total food energy, vitamin A, and calcium intakes below recommendations for both groups. The elderly American Indians consumed significantly greater amounts of total food enregy, protein, fat, and niacin than the non=Indians. This difference was likely due to the inclusion of traditional food in the American Indians' diets. Recommendations are made for the focus of nutrition education with this group.     

The evaluation of nutrition quality of adolescents living in residential schools at the province of Bia?ystok]

The aim of this study was an assessment of nutrition quality of adolescents living in boarding schools at the province of Bia?ystok. The investigations were carried out in the range of nutritional value and contamination level of lead, cadmium, mercury, copper and zinc in daily food rations given to young people. The nutrition quality was determined by calculating the energy and nutritional components during ten days (decade), using computer programme "Menu". Chemical analysis were made on individual meals, which create daily food ration per estimated day. All the studies (in 1997 and 1998 year) were done according to the methods referred in chapter on this article "Material and methods of research". It was found, (during two years study) that nutrition of young people in boarding schools devites from recommended dietary allowances. High products consumption from groups: "meat and its products", "butter" and "other fats", caused too high energy contribution taken from dietary fats of whole daily energy and high iron intake. The percent proportion from energy supplied from proteins was maintained in recommended value. The consumption deficit in groups "milk and dairy products", "vegetables and fruit rich in vitamin C reflected in the low percent of realization of the requirements for calcium and vitamin C. Exceedation of permissible tolerable weekly intake (PTWI) of cadmium and mercury wasn't stated, (in 1997 year) while 26% of estimated in 1997 year, and 14% in 1998 diets were above PTWI for lead. Daily intake of copper and zinc was lower than maximal tolerable daily intake (MTDI). Some assessed (during 1997 and 1998 year) rations didn't cover the requirements for zinc, while in 81% estimated diets in 1997 and 76% in 1998, the recommended intake level of copper was exceeded. The contents of sodium chloride in daily food rations analyzed in 1997 year ranged from 13.8 g to 27.2 g and the highest source of dietary salt were dinner meals (6.9 g-13.2 g), analogous in current year--from 10.8 g to 38.3 g, with contents of salt in dinner meals--5.7 g to 14.4 g. The investigation from 1997 and 1998 year prove, that nutrition of adolescent in boarding schools isn't correct according to rational diet principles. There is the need of giving systematic training for people who are planing and realising nutrition in boarding schools, and taking up other activity mobilizing personnel for higher engagement in young people nutrition problem.     

Nutritional knowledge, attitudes, and food patterns of women athletes

Nutritional knowledge, attitudes, and food patterns of women athletes at the University of Nebraska at Lincoln were studied. Mean test scores for nutritional knowledge were higher for questions relating to "nutrition for the athlete" than to "general nutrition." Attitudes toward nutrition were generally favorable, with a positive correlation between nutritional knowledge and attitudes. Athletes who had received some form of nutrition education had higher nutritional knowledge and attitude scores than those who had not. Respondents were especially concerned with diet as it relates to weight control; those with higher knowledge scores consistently followed food patterns for weight-control diets similar to those used in training and pre-event diets.     

Comments on dietary intake of drug-dependent persons.

Interviews by means of a questionnaire were used to study the food habits and estimate the nutritional value of food eaten by forty clients in a methadone maintenance program and nineteen clients in a drug detoxification program in a drug treatment center, Marin Open House, San Rafael, California. Although responses to the questionnaires were highly varied, many subjects reported that drugs did affect appetite or cause craving for certain foods. Patients in the detoxification program tended to eat meals either once or twice a day, whereas one-third of those in the methadone program ate three or more meals daily. Over 90 per cent of the clients reported eating snacks. Foods consumed in inadequate amounts included fruits and vegetables high in either vitamin A or ascorbic acid, liver and other meats, and whole grain and enriched cereals or bread. Food consumed as reported on a 24-hr. recall was evaluated by a computer program, and the tabulation was compared with the Recommended Dietary Allowances. Diets were considered to be inadequate if nutrient intakes were below two-thirds of the allowances. In general, the clients in the detoxification program consumed less adequate amounts of the nutrients studied than the methadone group. The females in both groups consumed less adequate diets than the males. About two-fifths of the men of both groups and about three-fourths of the women had diets inadequate in three or more nutrients by the standards chosen. In spite of the limitations of this study, the results do point to the existence and type of nutritional problems likely to be encountered in drug-dependent persons and in those undergoing treatment. The need for nutrition counseling is evident.     

惠州学院164名在校女生膳食营养状况调查

目的了解女大学生膳食营养状况,为开展高校膳食营养教育提供参考。方法采用24h膳食记录法和查帐法对惠州学院164名随机抽样的女大学生进行连续3d的膳食调查,通过实验室检查进行营养状况评价。结果惠州学院在校女生能量摄入量只占RNI的73%,钙摄入量只占RNI的42%;碳水化合物、维生素B1、维生素B2、铁、锌摄入量不足;动物性食品偏少;血液钙、镁、铁、铜、锌浓度偏低。结论惠州学院女生膳食结构不合理,应调整膳食结构,增加动物性食物的摄入,提高膳食能量、钙、维生素B1、维生素B2、微量元素的摄入量。     

Dimensions of Sandawe diet

Rural African children consuming plant‐based diets low in animal products are at risk for sub‐optimal zinc nutriture. Consequently, we investigated indigenous dietary strategies for inproving the zinc nutriture of rural southern Malawian and Ghanaian children.

Seasonal dietary intakes, and the portion sizes of foods consumed by 4–6 year old Malawian and Ghanaian girls (n = 112) were determined from 3‐day weighed food records. The optimal combination of food items for enhancing zinc bioavailability was determined by comparing the zinc content, and the phytate‐to‐zinc molar ratio (PZ) of isocaloric meals and snacks consumed by these girls. The energy content and portion sizes of the recommended meals and snacks were based on actual average intakes.

Results showed that in Malawi the amount of available zinc could be enhanced by using refined corn flour nsima or a non‐traditional fermented corn dough nsima with relishes prepared from small fish, and snacks with moderate to low PZ. In Ghana, fermented corn dough banku, or cocoyam, for root‐based meals, together with a soup/stew of small fish, and zinc‐dense snacks were recommended.