Background: Kenya is undergoing rapid urbanization resulting in changing lifestyles. Childhood dietary habits are changing and might result in childhood obesity and related health risks. Dietary habits learnt in early life are likely to be carried to adulthood. Nutrition knowledge and positive attitude are known to influence dietary practices. There is paucity of information on nutrition knowledge, attitude and practices of school-children in cities. This study established nutrition knowledge, attitude and practices among urban school children in Nairobi. Methods: A cross-sectional study was conducted among 202 school-children aged 8-11 years, systematically sampled from four randomly selected schools. Structured questionnaire, key informant interviews and focus group discussions were used to collect data. A nutrition knowledge score was determined (correct response: 1, incorrect: 0). Overall knowledge level was the total of correct responses in percentages. Scores of ≤40 %, 41-69 % and ≥70 % were categorized as low, moderate and high knowledge respectively. Dietary practices were determined from frequency of food consumption, habitual patterns and attitude on what they ate. Data were analyzed using SPSS. P-value of p < 0.05 was considered significant. Results: Pupils had moderate nutrition knowledge (mean score 5.16 ± 1.6, 51.6 %). 65 % did not care what they ate. About 82 % ate food in front of TV unsupervised. Over 70 % had consumed sweetened beverages and 73 % junk foods in previous 7 days. Only 9 % consumed fruits 4-7 times a week. Almost all study children carried money to school and made decision on foods to buy. Chips, candies, sausages and smokies, doughnuts and chocolate were preferred snacks. Nutrition knowledge had no significant relationship with dietary practices, but attitude had. Conclusion: Children had moderate nutrition knowledge and poor dietary practices, associated with negative dietary attitude. This study recommends activities to raise awareness on the effect of poor dietary practices on obesity and related health risks.

BackgroundResearch on trends in child undernutrition in Kenya has been hindered by the challenges of changing criteria for classifying undernutrition, and an emphasis in the literature on international comparisons of countries’ situations. There has been little attention to within-country trend analyses. This paper presents child undernutrition trend analyses from 1993 to 2008–09, using the 2006 WHO criteria for undernutrition. The analyses are decomposed by child’s sex and age, and by maternal education level, household Wealth Index, and province, to reveal any departures from the overall national trends.MethodsThe study uses the Kenya Demographic and Health Survey data collected from women aged 15–49 years and children aged 0–35 months in 1993, 1998, 2003 and 2008–09. Logistic regression was used to test trends.ResultsThe prevalence of wasting for boys and girls combined remained stable at the national level but declined significantly among girls aged 0–35 months (p < 0.05). While stunting prevalence remained stagnant generally, the trend for boys aged 0–35 months significantly decreased and that for girls aged 12–23 months significantly increased (p < 0.05). The pattern for underweight in most socio-demographic groups showed a decline.ConclusionThe national trends in childhood undernutrition in Kenya showed significant declines in underweight while trends in wasting and stunting were stagnant. Analyses disaggregated by demographic and socio-economic segments revealed some significant departures from these overall trends, some improving and some worsening. These findings support the importance of conducting trend analyses at detailed levels within countries, to inform the development of better-targeted childcare and feeding interventions.

The pattern of infant and young child feeding that provides the most benefit includes being put to the breast within an hour of birth, exclusive breastfeeding for 6 months, continued breastfeeding along with complementary foods up to 2 years of age or beyond, and avoidance of any bottle-feeding. However, since there are no published data from Kenya regarding trends in these feeding practices, this research undertook time trend estimation of these feeding practices using the 1998, 2003, and 2008-2009 Kenya Demographic and Health Survey and also examined the multivariate relationships between sociodemographic factors and feeding practices with data from 2008 to 2009. Logistic regression was used to test the significance of trends and to analyze sociodemographic characteristics associated with feeding practices. There was a significant decline in early initiation of breastfeeding among children in Central and Western provinces and those residing in urban areas. Trends in exclusive breastfeeding showed significant improvement in most sociodemographic segments, whereas trends in complementary feeding and breastfeeding remained stable. Bottle-feeding significantly decreased among children aged 12 to 23 months, as well as those living in Coast, Eastern, and Rift Valley provinces. In the multivariate analysis, the province was significantly associated with feeding practices, after controlling for child's size, birth order, and parity. The stagnant (and in some cases worsening) trends in early initiation of breastfeeding and complementary feeding with breastfeeding paint a worrisome picture of breastfeeding practices in Kenya; therefore, efforts to promote the most beneficial feeding practices should be intensified.

Objective: WHO BMI-for-age z score (BAZ) is widely used in epidemiology, yet it does not distinguish body fat-free mass and fat mass which are better indicators of obesity and related risks. The stable isotope dilution techniques (SIDT) are gold standard methods of assessing body composition. Main objective was to assess significant differences in measurement and validity of WHO BMI-for-age classification for defining childhood obesity by comparing with body fatness using SIDT among schoolchildren. Design: A cross-sectional analytical study. A questionnaire, anthropometry and body composition data were used. SPSS was used to analyse data at P < 0·05 at 95 % CI. Setting: Primary schools in Nairobi City County, Kenya Participants: One hundred seventy-nine schoolchildren aged 8–11 years were randomly sampled. Results: Prevalence of adiposity by reference SIDT (24·0 %) was significantly higher than that of obesity by BAZ > 2 sd (2·8 %) (Wilcoxon test, P < 0·05). Concordance coefficient between SIDT and BAZ > 2 sd in diagnosing obesity was poor (κ = 0·167). Only 11·6 % of children with excess body fat were correctly diagnosed as obese by BAZ > 2 sd. The use of BAZ > 1 sd for overweight and obesity showed fair concordance coefficient (κ = 0·409, P < 0·001) with 32·5% of children with excess fat positively identified as overweight and obese. Conclusion: WHO BMI-for-age cut-off points severely underestimate the prevalence of overweight and obesity compared with body composition assessment by stable isotope dilution techniques. Evidence-informed interventions should be based on more accurate estimates of overweight and obesity than that can be provided by BAZ.

Adequate dietary intake is important in achieving optimal nutrition and health for people before and during treatment of HIV. Inadequate nutrition causes health issues and fatalities among prisoners. Thus, this study assesses dietary intake and factors affecting food service among male prisoners living with HIV at selected prisons in Kenya. A cross sectional analytical study design was adopted on a sample of 113 male prisoners living with HIV, randomly sampled from 4 prisons. Data collection tools included a structured questionnaire used to collect demographic, 24 h recall and food frequency data. During data analysis, 24 h recall data was analyzed using Nutri-survey software, and further analysis via SPSS software. Results revealed that slightly more than half the prisoners (50.4%) were aged 36-53 years. Primary education was attained by 60.2% and secondary education by 21.2%. Mean dietary intake for macronutrients was: Energy (1815±218 Kcal), Protein (56±12 g), fat (32±6 g), Carbohydrates (322±45 g), Fiber (41±23 g) and PUFA (8±1 g). None attained Recommended Daily Allowances (RDA) for energy, fat and PUFAs. Mean key micronutrients were: Vitamin A (1195.1±812.7), Vitamin B6 (1.9±0.9), Vitamin C (55.7±18.4), Iron (10.2±2.7), Magnesium (488.1±152.3) and Zinc (13.9±6.7). None met RDA for Iron. Therefore, provision of a nutritionally balanced diet in prisons can ensure nutrients adequacy.