Chronic diseases of lifestyle are increasing in global prevalence and they threaten developing nations' ability to improve the health of their populations. Previously, lifestyle diseases were thought to be diseases of the affluent but poor populations are now equally affected. This is largely due to the environment in which the poor reside and socio-economic circumstances that influence their diets and physical activity patterns. This study aimed at determining the association between socio-economic status, knowledge, awareness, and attitudes and the prevalence of obesity, diagnosed diabetes and hypertension in the Swahili community of Old Town and Kisauni districts in Mombasa County, Kenya. A cross-sectional study design was administered. Cluster sampling was used to randomly pick the 207 households. Data was collected using a semi-structured researcher administered questionnaire. Knowledge, awareness and attitudes were addressed using questions on balanced diet, healthy eating, healthy body weight, obesity, diabetes, hypertension and diabetes and hypertension causes. Socioeconomic status was addressed by questions on the educational levels, occupation and income. Focus Group Discussions and Key Informants Interviews were used to collect qualitative data. Data analysis was done using the Statistical Package for the Social Sciences version 11.5 computer software. Results indicate that about 36.8% of the individuals had at least primary education. Most (69.1%) of the women were housewives while the men had businesses and others were employed. They had average knowledge and were aware of healthy eating, obesity, diabetes and hypertension. Diagnosed diabetes in both Old Town and Kisauni districts was predicted by obesity, knowledge on obesity and knowledge on diabetes (p= 0.000). In Old town, the major predictors of hypertension were obesity, knowledge on obesity and physical inactivity (p= 0.044). There is, therefore, need to develop educational policies and programs to create awareness and knowledge among the members of the Swahili community. The community should be educated on lifestyle disease causes and prevention in order to reduce their risk of developing the diseases.

Probiotics are live microbial feed supplements, which positively affect the host animal by improving its intestinal microbial balance. Studies have shown probiotic activities of Lactococci isolated from dairy foods, which include the ability to inhibit the growth of other bacteria and the reduction of cholesterol. However, there is limited documented work on the probiotic activity in Lactococci from plant materials. The present study isolated and tested cholesterol reduction ability (in-vitro) of Lactococcus lactis isolates from fermented smooth pigweed (Amaranthus hybridus) leaves. The specific objectives were to: isolate L. lactis bacteria from A. hybridus leaves harvested at maturity (30 days), determine cholesterol reduction ability of L. lactis isolated from the A. hybridus leaves and establish whether there were any differences in the amounts of cholesterol reduced from the growth media by L. lactis and Lactobacillus acidophilus ATCC 43121 (the positive control). It further aimed at determining whether fermentation affected protein, mineral and moisture content in amaranthus leaves and the acceptability of the fermented leaves as compared to fresh boiled leaves. To achieve this, A. hybridus was grown at Kenya Agricultural Research Institute in Njoro. The leaves were harvested at maturity and fermented for five days. After fermentation, L. lactis strains were isolated and their ability to remove cholesterol from the growth medium tested. This ability was compared with that of Lb. acidophilus ATCC 43121. Consumer acceptability of the fermented leaves was also compared to freshly boiled leaves. The Lactococcal strains isolated reduced cholesterol level by 52 µg/ml and Lb. acidophilus ATCC 43121 reduced by 56 µg/ml indicating a similar reduction capability (p < 0.05) to that of the standard Lb. acidophilus ATCC 43121 probiotic. After fermentation, protein decreased from 36.07 to 16.65%, ash increased from 19.76 to 36.21% and moisture content increased from 5.44 to 6.22%, respectively.There was no significant difference (p < 0.05) in consumer acceptability whereby, the consumers scored 6.90 points for fermented leaves compared to av6.83 points scored by consumers for fresh boiled leaves This study concluded that fermented amaranthus leaves dish is a potential source of probiotics as the level of cholesterol reduction by the isolated Lactococcal strains compares favourably with the reduction levels of the control Lb. acidophilus ATCC 43121 which is a known probiotic.

The effect of maternal dietary intakes on pregnancy outcomes was assessed in a descriptive , cross -sectional survey among women attending the Prevention of Mother - to-Child Transmission (PMTCT) of HIV program at Nyanza Provincial General Hospital (NPGH) , Kenya. A Purposive sampling procedure was employed to select pregnant women (n=107) who had been tested for HIV into the study. Data on socio - demographic characteristics , health factors, dietary intakes and pregnancy outcomes were collected through an interview schedule from HIV -infected (n=48) and uninfected (n=59) pregnant women. Maternal dietary intakes were investigated using 24- Hour Diet Recalls and Food Frequency Questionnaires (FFQs) . Pregnancy outcomes were assessed in terms of infants’ birth weights, gestational age, birth complications and stillbirths. Statistical Package for the Social Sciences (SPSS ) was used to analyze data for descriptive and inferential statistics while NutriSurvey computer program analyzed dietary data for nutrient intake levels . The results showed that protein ( p = 0.025) and vitamin B 12 (p = 0.021) intakes had significant correlation with infant ’s gestational age among the HIV -infected women while calorie (p = 0.042) , vitamin B 6 ( p = 0.048 ) and vitamin B 12 ( p = 0.015) intakes significantly influenced infant ’s gestational age among uninfected women . Magnesium, iron and folate had a significant influence (p < 0.05) on infant ’s gestational age in both HIV - infected and uninfected mothers. The results further revealed that HIV -infected women gave birth to infants of low birth weight (2.70 ± 0.3799 kg) compared with those uninfected (3.16 ± 0.5307 kg), while the gestational age of infants born to HIV - infected mothers was shorter ( 34.6 ± 3.24 weeks) compared with that of infants born to uninfected mothers ( 39.4 ± 2.21 weeks ). The study concluded that both HIV and dietary intake have significant effects on pregnancy outcomes . It is imperative , therefore, that appropriate nutrition intervention be put in place to improve mater nal health during HIV infection to ensure favourable pregnancy outcomes.

Consumption of poor-quality diets was noted as prevalent in the Lake Victoria Region, Kenya. As a strategy to communicate desirable change and promote healthy eating in the region, a 30-member panel of policymakers and implementers developed and proposed 12 food-based dietary guidelines (FBDGs) in 2017-2018. The objective of this study was to assess barriers in adopting the proposed FBDGs amongst community members in the lowlands of Kisumu and Homa Bay counties. Qualitative, descriptive cross-sectional design was used to collect data from 72 focus-group discussions (FGD). The FGD was conducted among 216 school going children (10-13y), 216 high school students (15-18y), 207 adult males (26-74y) and 211 females (18-71y). The participants were asked to state whether the proposed FBDGs reflected their daily dietary practices? If the answer was no, the FGD participants were asked to elaborate on the perceived barriers. Each FGD consisted of 8-12 participants. The demographics of FGD participants were collected before the start of FGD sessions. All FGD proceedings were audio-recorded and transcribed verbatim. Demographic information of participants was analyzed and presented using descriptive statistics. The FGD responses were coded and analyzed based on the main code, the barriers. Barriers to healthy eating in the study area were mainly linked to low production of food, food unavailability and inaccessibility. Specific factors which contributed to the food insecurity situation included; dry and sunny weather, seasonality in food availability, limited resources to secure potential farmland with fences, gender influence on land use, high cost of food, lack of money to purchase food, low income, sale of farm produce with resultant inadequate quantities of food consumed and inappropriate meal composition. Food insecurity was a perceived barrier to healthy eating in the lowlands of the Lake Victoria region. This research suggests the need to address food systems and economic structures to improve food production, distribution, accessibility and consumption in the region. Coding was done with the aid of NVivo8 (QSR International Pty Ltd Version 8, 2008). This study was registered with the Kenyan National Commission for Science Technology and Innovation (NACOSTI/P/18/12634/22291). Key words: Healthy eating, Lake Victoria, barriers, food insecurity, food unavailability, food inaccessibility