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.

Background and objectivesGlobally, children aged under five years are prone to malnutrition. Maasai are a nomadic community in Kenya still upholding traditional and has a high rate of child undernutrition. Consideration of cultural practices is a pre-condition for ensuring appropriate dietary practices. However, information on the influence of culture on dietary practices among Maasai children is minimal. The possible influence of culture on dietary practices among these children was investigated.MethodsSix focus group discussions sessions each consisting of 10 mothers were conducted from two randomly selected villages in Sajiloni location, Kajiado County.ResultsResults from this study showed that children mainly consume cereals and legumes. Nomadism makes animal products inaccessible to most children. Livestock are considered a sign of wealth, thus mainly slaughtered on special occasions. Additionally, selling of animals or animal products is not encouraged limiting income that would improve the food basket. Some food taboos prohibit consumption of wild animals, chicken and fish limits the household food diversity. Consumption of vegetables is limited since they are perceived to be livestock feed. The belief that land is only for grazing contributes to low crop production and consumption thus the diets lack diversification. Maasai culture encourages introduction of blood, animal’s milk and bitter herbs to infants below six months, which affects exclusive breast feeding. The men are prioritized in food serving leading to less and poor quality food to children. The consumption of raw meat, milk and blood is likely to lead to infections. The practice of milk fermentation improves bioavailability of micronutrients and food safety. Socialism ensures sharing of available food while believe in traditional medicine hinder visit to health facilities thus no access to nutrition education.ConclusionThis study concludes that culture influence the dietary practices among children under five years. It recommended initiation of programs to create awareness on how the beliefs negatively affect dietary practices with a view for a change.

BackgroundHIV and AIDS affect most the productive people, leading to reduced capacity to either produce food or generate income. Children under-fives are the most vulnerable group in the affected households. There exists minimal information on food security status and its effect on nutritional status of children under-fives in households affected by HIV and AIDS. The aim of this study was to assess food security and nutritional status of children under-five in households affected by HIV and AIDS in Kiandutu informal settlement, Kiambu County.MethodsA cross-sectional analytical design was used. A formula by Fisher was used to calculate the desired sample size of 286. Systematic random sampling was used to select the children from a list of identified households affected by HIV. A questionnaire was used to collect data. Focus group discussion (FGD) guides were used to collect qualitative data. Nutri-survey software was used for analysis of nutrient intake while ENA for SMART software for nutritional status. Data were analyzed using SPSS computer software for frequency and means. Qualitative data was coded and summarized to capture the emerging themesResults and discussionResults show that HIV affected the occupation of people with majority being casual laborers (37.3 %), thus affecting the engagement in high income generating activities. Pearson correlation coefficient showed a significant relationship between dietary diversity score and energy intake (r = 0.54 p = 0.044) and intake of vitamin A, iron, and zinc (p < 0.05). A significant relationship was also noted on energy intake and nutritional status (r = 0.78 p = 0.038). Results from FGD noted that HIV status affected the occupation due to stigma and frequent episodes of illness. The main source of food was purchasing (52.7 %). With majority (54.1 %) of the households earning a monthly income less than US$ 65, and most of the income (25.7 %) being used for medication, there was food insecurity as indicated by a mean household dietary diversity score of 3.4 ± 0.2. This together with less number of meals per day (3.26 ± 0.07 SD) led to consumption of inadequate nutrients by 11.4, 73.9, 67.7, and 49.2 % for energy, vitamin A, iron, and zinc, respectively. This resulted to poor nutritional status noted by a prevalence of 9.9 % in wasting. Stunting and underweight was 17.5 and 5.5 %, respectively. Qualitative data shows that the stigma due to HIV affected the occupation and ability to earn income.ConclusionsThe research recommends a food-based intervention program among the already malnourished children.

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.