There is a scarcity of information on dietary intake and iron status of Ghanaian children raised on vegetarian diets. A cross-sectional study design was used to compare the diets and iron status of vegetarian children between the ages of 9 months and 11 years (n= 26) with matched controls, non-vegetarian children (n=26) of similar ages and same sex and living within the same communities in Accra and Cape Coast, Ghana. Dietary information was collected using 24-hr food recall and 12-hr home observation. Haemoglobin, plasma ferritin, C-reactive protein, and Transferrin Receptor (TfR) concentrations were determined on finger prick (haemoglobin) and venous blood samples collected during the study. Based on the 24-hr food recall, vegetarian children’s diets were devoid of vitamin B12whereas non-vegetarian children’s diets were not (0.0 ± 0.0 mg vs. 1.5 ± 1.8 mg, p<0.001). The dietary intake based on 12-hr home observation showed similar results. However, vegetarians had significantly higher intake of dietary fibre (17.1 ± 11.9 g vs. 8.4 ± 6.2 g, p= 0.002), thiamine (1.1 ± 0.8 mg vs. 0.5 ± 0.3 mg, p= 0.001) and vitamin A (1702 ± 1887 Retinol Equivalent (RE)vs. 671 ± 691 RE, p= 0.010) than non-vegetarian children. Dietary diversity based on nine food groups was similar between groups (5.8 ±1.0score). Plasma ferritin was higher for non-vegetarian children compared to the vegetarians (59.2± 48.2 ng/mL vs. 34.1± 25.8ng/ml, p= 0.012) but there was no group difference in plasma TfR. The prevalence of anaemia was about 25% in both groups. Typical diets of Ghanaian children lack variety and both vegetarian and nonvegetarian diets are insufficient to support adequate iron status. Iron-rich foods such as meat or supplements are needed. There is urgent need for immediate vitamin B12 supplementation for all vegetarian children and a general need for nutrition education to diversify all children’s diets.
Indicators of poor maternal mental health have been associated with non-responsive feeding styles that affect dietary intake in infants. This study examined the association between maternal mental health indicators and infant dietary intake and infant feeding behaviors within a 2003 to 2008 longitudinal observational cohort study in Ghana (the Research to Improve Infant Nutrition and Growth [RIING] project). A random sample of one third of the RIING cohort (19 HIV positive [HIV-P], 29 HIV negative [HIV-N], and 24 HIV unknown [HIV-U]) and their infants was selected for an in-home 24-hr weighed dietary study at 9 months postpartum. Maternal depressive symptoms and perceived stress scores had been measured at 6 months using the Edinburgh Postnatal Depression Scale (EPDS) and Perceived Stress Scale (PSS), respectively. All foods and liquids were weighed to determine energy and nutrient intake values. Human milk intake was weighed. Each feeding session was observed, and the feeding style was recorded. Multiple linear regression showed that maternal perceived stress was negatively associated with total food (-12.4 g, 95% CI: -21.0 to -3.8), energy (-19.5 kcal, 95% CI: -33.8 to -5.2), and fat (-0.7 g, 95% CI: -1.4 to -0.1) intake from complementary foods and liquids in infants. An HIV-P status was associated with a lower intake of fat (-6.3 g, 95% CI: -11.1 to -1.5) and vitamin A (-293.9 µg, 95% CI: -529.9 to -57.8) compared to HIV-N. Maternal mental health indicators were not associated with feeding style. However, a positive feeding style was associated with a higher intake of fat (4.8 g, 95% CI: 0.3 to 9.2) and vitamin A (245.3 µg, 95% CI: 28.2 to 462.5) compared to a passive feeding style. This study highlights the importance of focusing on how the infants are fed during the complementary feeding period. Interventions to improve infant dietary intake should prioritize maternal mental health and promote positive feeding styles among high-risk caregivers. Key words: maternal depression, perceived stress, HIV, infant, feeding style, diet, Ghana
Adequate maternal nutrition prior to pregnancy is important for maternal health and favourable pregnancy outcomes. However, information on the dietary intakes of NonPregnant, Non-Lactating (NPNL) women in Ghana is lacking. A cross-sectional survey was undertaken to compare the dietary intakes of NPNL women of children aged 2 to 5 years who are either living in the Coastal (n=79) or Guinea Savannah (n=89) zones. Data were collected using various methods namely interviewer administered socio-demographic questionnaire, 24hr dietary recall records, with data collected on one working and one non-working day within a week, and a 1-week food frequency questionnaire. Body mass index was derived from height and weight measurements. Women in the Coastal Savannah zone had significantly (p=0.05) more formal education (3.9 ± 2.5 years) and earned a higher (p<0.001) weekly income (Gh¢ 6.8 ± 2.7) than women in the Guinea Savannah zone with educational level and incomes of 2.2±1.6 years and Gh¢ 3.9±2.4 respectively. More women in the Coastal zone had significantly (p<0.05) fewer births and were heads of their households. Cereal-based foods were consumed daily by all women during the two-day observation period. Fish was the predominant animal source food in the diet in both zones. Significantly (p<0.05) more women in the Guinea Savannah zone did not meet their Estimated Average Requirements (EAR) for protein (81%), vitamin A (94.4%), and vitamin C (72%) compared to women in the Coastal zone (44%, 22%, and 31% respectively).The diets of both groups of women were low in calcium. Generally, women in the Coastal zone had a significantly (p<0.001) higher BMI (24.2 ± 4.6 kg/m2) than their counterparts in the Guinea Savannah zone (21.3± 2.4 kg/m2).The overall quality of dietary intakes and nutritional status of women in the Guinea Savannah zone was poorer than that of Coastal women. Dietary deficiencies are also present in NPNL women in Ghana. Efforts are needed to improve diet quality and to increase access to resources especially for women in the Guinea Savannah zone of Ghana.
Anemia remains a serious public health concern, globally, affecting learning ability and physical development of children. Anemic children are at a higher risk of diminished economic productivity and low earning capacity in adulthood due to impaired school performance and reduced work capacity. Anemia contributes to about a quarter of Africa’s nutrition-related Disability Adjusted Life Years. The objective of this study was to determine the prevalence of anemia and its associated risk factors among school-aged children (SAC) between ages 9 and 15 years in urban Ghana. The analysis included a randomly selected subsample of 1,634 children from a larger study on nutrition of SAC enrolled between 2009 and 2012 in private and public basic schools in the Accra and Kumasi Metropolis in Ghana. Socio-demographic and household characteristics were collected with questionnaires. Weight and height were taken to the nearest 0.1kg and 0.1cm, respectively. Dietary information was collected using a food frequency questionnaire. Data were analyzed using IBM SPSS Statistic version 23. The relationship between hemoglobin levels and socio-demographic variables, and predictors of hemoglobin levels were determined using Chi-square and binary logistic regression. The mean hemoglobin concentration of the study participants was 12.9±1.3 g/dL. In Kumasi, SAC had higher mean hemoglobin concentration (13.1±1.2 g/dL) compared to those from Accra (12.6±1.3 g/dL; p=0.001). Mean hemoglobin concentration was significantly higher among males than females (13.0±1.4 g/dL vs 12.8±1.2 g/dL; p=0.002). Prevalence of anemia was 20.4%; mild anemia was most common (13.6% of total sample). Anemia cases were higher in public schools (24.6%) compared to private (18.2%). Two-thirds of anemia cases (64.0%) were from schools in Accra. Males had significantly higher prevalence of anemia (26.5%) than females (15.9%; p <0.05). In the adjusted logistic regression model, only city of residence (OR+1.65, 95% CI: 1.44–1.83), thinness (OR=2.60, 95% CI: 1.11-5.75), stunting (OR=1.85, 95% CI: 1.99-3.10) and overweight (OR=0.60, 95% CI: 0.36-0.94) were significantly associated with anemia. In this study, anemia was significantly associated with location and nutritional status. Key words: anemia, Ghana, hemoglobin, schoolchildren, urban settings, metropolis, Accra, Kumasi
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