Associations of diet quality with dairy group membership, membership duration and non-membership for Kenyan farm women and children: a comparative study

Abstract

Objective: To examine associations among diet quality and dairy group membership, membership duration and non-member status for women and school-aged children in rural Kenya. Design: A cross-sectional survey, using chain referral sampling, was conducted and diet quality indices and prevalence of inadequate intake (PII) were estimated using the 'estimated average requirement' cut-off point method from single 24 h recalls, using a Kenyan nutrient database. PII was compared among members and non-members and among membership-duration groups. Subjects: Women and children of dairy group members (n 88), across membership-duration groups (1-3, 4-6, 7-9 and 101 years), and non-members (n 23) living among members. Setting: Small farms in central Kenya. Results: Members had higher energy, percentage of energy from animal-source foods and dietary diversity. Member women and children had lower PII for respectively seven and three of eleven micronutrients. Reduced PII for milk-source micronutrients was associated with membership duration for women. Many member women (38 %) had inadequate vitamin A intake and 39 % of member children had inadequate Zn intake. Members' PII was also high (.45 %) for Fe, Ca and vitamin B 12 . A higher prevalence of being overweight among member women compared with non-member women suggested nutrition transition effects of higher farm productivity. Conclusions: Dairy group membership was positively associated with adequate quantity and quality of diets for women and children. Long-term membership was insufficient to address micronutrient deficiencies. Understanding and addressing barriers to better diet quality and strategies to mitigate negative nutrition transition effects are needed to optimize nutritional outcomes of dairy group membership.

Effect of nutrition education and dairy group membership on nutrition knowledge, practices and diet quality for rural Kenyan farm women

“…Approximately 40% of Kenyan women experience vitamin A deficiency [30] and our previous research that found a high proportion of the study group had inadequate vitamin A intake [16]. Independent of dairy group membership, the positive effects on DGLV and OF consumption and vitamin A intake may be explained by a displacement of 'other fruit and vegetables' in response to intervention messages.…”

“…Stemming from these efforts, significant improvements in dairy animal feeding, reproduction, mastitis control, [14] and milk production were reported [15]. As well, WDL members had higher dairy income, greater household food security, consumed more milk, and had better quality homes, water access and social support compared to non-members [16]. However, average dietary diversity (DD) was low (less than five) for member and non-member women.…”

“…Low DD is associated with inadequate intake of multiple micronutrients for women [3]. Correspondingly, member and non-member women had inadequate intake of iron (65% of member women and 70% of non-member), zinc (20% and 14% of member and non-member women, respectively) and vitamin A intake (28% of member and 65% of non-member women) [16].…”

“…Specifically, food preparation methods to increase the micronutrient density of typical foods (modifying recipes and adding available vegetables and fruit) and methods to reduce intake of anti-nutrients (phytates and tannins) [21] were promoted. The focus on vitamin A, iron, and zinc was based on known deficiencies for women in Kenya and other developing countries [3] and the study group [16]. Typical foods were prepared using the strategies being promoted:…”

“…Pre-and post-intervention, women's food intake data were collected using a single four-pass 24-hour diet recall [16,28]. Nutrition knowledge and practices data was collected using an adapted structured questionnaire [29].…”