Masters Degrees (Nutrition and Dietetics)
Permanent URI for this collection
Browse
Browsing Masters Degrees (Nutrition and Dietetics) by Advisor "Kehlenbeck, K."
Now showing 1 - 1 of 1
Results Per Page
Sort Options
Item Open Access Fruit consumption in relation to health and nutritional status fo children below 5 years and their mothers/caregivers in farming households of Western Kenya(University of the Free State, 2014-12-09) Imbumi, Maryam; Walsh, C. M.; Kehlenbeck, K.English: Malnutrition is a global problem that affects especially children below 5 years, manifesting as underweight, stunting and wasting. Factors that contribute to malnutrition include food insecurity, poor dietary diversity and illness. At a more basic level, socio-demographic factors are closely associated with malnutrition. Fruits and products made from indigenous fruits constitute one of the cheapest yet richest sources of food, on which the poor (especially women and children) depend. Fruits are nutrient-dense and may play an important role in addressing deficiencies related to malnutrition. However, the value of fruits in addressing malnutrition by contributing to food security and dietary diversity remains largely undetermined in Kenya. The objective of the present study was to determine socio-economic status, nutritional status (anthropometry, food security, dietary diversity), and associations between these factors in children under 5 years and their mothers with different levels of fruit consumption in selected farm households of Western Kenya. Data was collected in rural Busia and Kakamega districts between March to June 2013 after approval from all relevant parties had been obtained. Of the 96 households sampled, 45 were from Busia and 52 from Kakamega. All children 6-59 months old and their mothers were eligible to participate. Anthropometric measurements of mother and child were taken at the household. Thereafter, questionnaires related to the following were completed: socio-demography; household food security and procurement; household dietary diversity; and reported health. Descriptive statistics, that include frequencies and percentages for categorical data and means and medians for continuous data were calculated and compared for groups with fruit consumption above the median of one fruit per day and with fruit consumption below the median of one fruit per day. Associations between variables were calculated using two-by-two tables and described by means of 95% confidence intervals. All children and the majority of mothers took in less than the recommended 400 g of fruit and vegetables per day. Most mothers that consumed less than the median of one fruit per day, also had children with a low fruit consumption. On the other hand, mothers that had fruit consumption higher than 1 fruit per day, also had children with a higher fruit consumption. As far as socio-demographic indicators are concerned, no significant differences between the two groups were identified. Most of the participants were from humid lower midland (LM1) and semi-humid lower midland (LM2) and most spoke Luhya. A large percentage of participants lived in traditional mud houses (give percentages of two groups) and used pit latrines. Both groups had high room density (median of 4-5 persons per room), poor water supply (less than 7% had a communal tap), lack of household appliances (less than 10% had a working refrigerator or stove) and low income. A large percentage of all mothers were unemployed (68.8% of those with a lower fruit intake and 75% of those with a higher fruit intake). Both groups used open fire for cooking most of the time. There was a tendency for households with a lower fruit intake to be more likely to have wages and salaries from formal employment as their main source of income than households with a higher fruit intake (95%CI for percentage difference [ -2.7% ; 27.3% ]). On the other hand, there was a tendency for households with a higher fruit intake to have crop production and livestock sales as their main source of income when compared to households with a lower fruit intake (95%CI for percentage difference [ -36.4% ; 0.8% ]). As far as household food security and food procurement indicators are concerned, significantly more households with a higher fruit intake grew sweet potato (95% CI of [-38.2% ; -5.1% ]) and African nightshades (95% CI of [-38.3% ; -0.2% ]) than those with a lower fruit intake. Mothers with a higher fruit intake were more likely to grow mangoes, avocados, jackfruit and lemons than those with a lower fruit intake, but the differences did not reach statistical significance. There was a tendency for more households in the group with a higher fruit intake to produce enough food to last till the next season compared to the group with a lower fruit intake (95% CI [-31.4%; 3.4%]), while those with a lower fruit intake were less likely to have enough land to produce food that could last till next season (95% CI). A significantly higher percentage of respondents with a higher fruit intake reported that fruits were easily available from local farmers and shops than in the group with a lower fruit intake (95% CI of [ -45.5% ; -10.0% ]). A significantly higher percentage of mothers with a lower fruit intake reported eating less than should be eaten because there was not enough money for food than mothers with a higher fruit intake (95% CI of [1.6% ; 31.3%]). As far as household dietary diversity is concerned, both groups consumed cereals, white roots and tubers on the day preceding the interview. Fewer than half of households consumed fruits on the day preceding the interview (60% in the case of households with mothers that consumed less than the median of 1 fruit per day). In addition, very few households consumed meat, eggs or milk on the day preceding the interview. On the other hand, a high percentage of all participants consumed sweets, oils, fats, and beverages (more in the group with a lower fruit intake). Consumption of these less healthy foods contributed to the fact that most households had a Dietary Diversity Score that fell in the high category (≥ 6 food groups from a possible 12 food groups), despite not eating adequate amounts of healthier food groups. In both groups the median number of food groups consumed was 7 (ranging from 3 to 10). Although there was a tendency to obtain fruits through purchasing, rather than through own production, gathering, hunting and fishing in the group with a lower fruit intake, the difference between the two groups was not statistically significant (95%CI for percentage difference [ -9.2% ; 29.0% ]). As far as anthropometric indicators are concerned, median body mass index (BMI) of mothers in both groups fell within the normal range of 18.5 – 25 kg/m2 (21.2 kg/m2 for mothers with a lower fruit intake and 22.4 kg/m2 for mothers with a higher fruit intake). Mothers with higher fruit consumption were, however, more likely to have a higher BMI (still within the normal range) and waist circumference and were less likely to have stunted children. A significantly higher percentage of children in the group of mothers with a lower fruit intake were stunted (31.3%) compared to children of mothers with a higher fruit intake (8.3%) (95% CI for percentage difference [7.0%; 37.9%]). As far as weight-for-age is concerned, 8.3% of children of mothers with a lower fruit intake were underweight, compared to 4.2% in the group of children with mothers that had a higher fruit intake (difference not statistically significant). Despite having similar levels of socio-demography, households that were involved in food crop production and livestock sales, were less likely to suffer from food insecurity. Higher fruit consumption was associated with growing foods such as sweet potatoes and African nightshade and with a lower likelihood of experiencing hunger. Mothers with higher fruit consumption (although still inadequate in terms of international guidelines), were more likely to have a higher BMI (within the normal range) and normal waist circumference and were less likely to have stunted children. Programmes that focus on improving food production at the household level can make a meaningful contribution to addressing indicators of malnutrition (especially stunting) and food security.