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Background: Adequate nutrition is required for growth and development in children. This study tested the effectiveness of nutrition education on knowledge and BMI-for-age (BFA) of school-aged children in the Kumasi Metropolis. Methods: Children, aged 9-13 years old were recruited from ten randomly selected primary schools in the Metropolis. The schools were randomly allocated into 3 groups: nutrition education (3 schools), physical activity (PA) education (3 schools), both interventions (2 schools), or control (2 schools). Following a baseline nutrition and PA knowledge and status assess- ment in 433 children, twice-monthly nutrition and PA education and demonstrations were carried out for 6 months, followed by a post-intervention assessment. Results: PA and nutrition knowledge improved in all groups (P

BackgroundAdolescence is a critical stage in the life cycle that presents a window of opportunity for the formation of lifetime habits or an aversion to childhood malnutrition effects. This study assessed the lifestyle habits, macronutrient intakes, and obesity prevalence among adolescents in some selected Senior High Schools in rural communities in Ho Municipality.Materials and methodsA cross-sectional survey was conducted among 272 adolescents aged 13–19 years and attending senior high schools in the Ho Municipality of Ghana. Data on sociodemographic, physical activity levels, dietary habits, and anthropometrics were obtained. A body mass index (BMI) and waist circumference (WC) were determined, while a repeated 24-h dietary recall was used to collect the dietary intakes of the participants.ResultsThe majority of the adolescents did not meet the Recommended Dietary Allowances (RDA) for calories (94.5%), dietary protein (68.8%), and fibre (91.5%). Adolescent boys consumed more calories (1,969.7 ± 579.9 Kcal) on average than adolescent girls (1,658.0 ± 458.7 Kcal) (p = 0.001). Overweight and obesity prevalence were 15.8 and 8.5%, respectively. About 90.4% of the adolescents did not meet the WHO recommended 150 min per week of physical exercise. On sedentary, 97.6% of adolescents spent half an hour to 5 h per day watching television when at home. Breakfast was the most frequently skipped meal (47.9%), and 59.6% of adolescents consumed fast foods such as pizza, burgers, and ice cream one to three times per week. Adolescent girls also had higher odds of being overweight or obese compared with adolescent boys (AOR = 2.4, p = 0.094, 95% CI = 0.9–6.4). Adolescents who did not meet the RDA for calories had lower odds of being overweight or obese compared with those who did (UOR = 0.3, p = 0.045, 95% CI = 0.1–0.9).ConclusionPoor dietary habits and intake, sedentary lifestyle, and obesity prevalence were observed among the adolescents. Being an adolescent girl was associated with obesity risk, while not meeting caloric intake showed a protective effect. Efficient and effective nutrition and lifestyle education programme should be promoted in communities to improve the dietary intake and lifestyle habits of adolescents.

BACKGROUND: Older adults, both institutionalized and free-living are vulnerable to nutritional deficiencies and poor nutritional status, which affect morbidity and quality of life amongst them. Yet, little attention on nutritional needs is given to this vulnerable group in many developing countries, and very little data exist on the nutritional status of older Ghanaians. OBJECTIVE: This study assessed dietary intakes, anthropometric status, and anaemia prevalence among older adults in Effutu Municipality, Ghana. METHODS: Using a cross-sectional design, anthropometry, repeated 24-hour dietary recall, haemoglobin levels were determined among 150 older adults (60–87 years). The Mini Nutritional Assessment (MNA) questionnaire was used to determine malnutrition prevalence among older adults. RESULTS: None of the older adults met estimated average requirement (EAR) and adequate intake (AI) for vitamin E and calcium respectively, and 72.0%, 71.3%, 99.3%, 98.7%,76.0% had insufficient intake for energy, protein, zinc, folate and vitamin C respectively. Also, 39.3% were anaemic using haemoglobin cut-offs, 12.0% were malnourished based on the MNA tool and 28.0% were underweight based on BMI index. Married older adults (OR = 0.1, p = 0.005, 95% CI = 0.1–0.5) had lower odds for anaemia than those who were divorced. Underweight participants had 11.7 increased odds of being anaemic (OR = 11.7, p = 0.048, 95% CI = 1.0–135.0) than overweight participants. Those who had adequate vitamin C (OR = 0.3, p = 0.018, 95% CI = 0.1–0.8) and folate (OR = 0.2, p = 0.396, 95% CI = 0.1–6.7) intakes had lower odds of being anaemic than those with inadequate vitamin C and folate intakes, while those who had adequate iron (OR = 1.4, p = 0.412, 95% CI = 0.6–3.2) and vitamin B12 (OR = 1.6, p = 0.473, 95% CI = 0.5–5.3) intakes were more likely to be anaemic CONCLUSIONS: Inadequate nutrient intakes, anaemia, underweight and malnutrition prevalence were found among these older adults. Anaemia was associated with being underweight, but not nutrients intake. The nutritional needs of older people should be addressed to reduce risks for disease.

Background Poor Knowledge, Attitude, and Practices (KAP) of food safety and hygiene by foodservice providers lead to food contamination and pose health threats to consumers. This study assessed the...

Evidence shows a link between methyl-donor nutrient intakes and a child's cognitive ability. However, this is less known among Ghanaian children who might be at higher risk of methyl-donor nutrient deficiencies. This study showed comparative analysis of methyl-donor nutrient intakes and Raven's Coloured Progressive Matrices (RCPM) test performance among 2073 Ghanaian school children aged 9-13 years across four regions of Ghana.Data for the present study were obtained from the Child Nutrition, Fitness, and Cognition project; a cross-sectional survey conducted in four regions of Ghana. Dietary methyl-donor nutrient values were based on repeated 24 h recall data collected during the study periods. Cognitive tests were performed on the 2073 children using Raven's Coloured Progressive Matrices (RCPM) test.We found dietary zinc (adjusted: β = 0.21, p = 0.003) and methionine (adjusted: β = 0.60, p = 0.044) intakes to be associated with RCPM scores in the linear regression model. School children living in Northern Region (adjusted OR = 0.6, p 0.001, 95% CI = 0.4-0.7) and Volta Region (adjusted OR = 0.7, p = 0.006, 95% CI = 0.5-0.9) had lower odds of scoring above the 50th percentile on the RCPM test compared with those living in Greater Accra Region. Children who consumed below the RDA for dietary folate (unadjusted OR = 0.8, p = 0.055, 95% CI = 0.7-1.0) and zinc (unadjusted OR = 0.8, p = 0.049, 95%CI = 0.7-1.0) had lower odds of scoring above the 50th percentile on the RCPM test compared with those who consumed above the RDA for dietary folate and zinc respectively. Children who consumed below the EAR for dietary vitamin BHigher dietary methionine intake was strongly associated with higher RCPM scores. Regional differences, and children's dietary consumption below the EAR/RDA for dietary folate, vitamin B

Nutrients are critical for optimal brain development, and good nutritional status is associated with cognitive development and improvement. The relationship between micronutrients intake and cognition in Ghanaian school‐aged children has not been studied. The study investigated dietary intakes of micronutrients and cognition test performance of school‐aged children. A cross‐sectional study was undertaken among 438 school children, aged 9–13 years from ten randomly selected basic schools in Kumasi, Ghana. Socio‐demographic data were obtained from a structured questionnaire. Dietary intakes of iron, zinc, vitamin B6, folate, vitamin B12, and vitamin A were determined from repeated 24‐hr dietary recall data from 351 children, while cognition test was performed using a Raven's Coloured Progressive Matrices (RCPM), a 36‐question test. Among 351 children, 156 (44.4%) had inadequate zinc intake, whereas 96 (27.4%) had inadequate iron intake. More than 1 in 2 children had inadequate vitamin A intake while 55.8% and 53.0% had inadequate vitamin B12 and folate intakes, respectively. More school‐aged boys (66.3%) than girls (46.8%) had inadequate vitamin B12 intake (χ 2 = 13.393, p

BackgroundDietary diversity, a qualitative measure of dietary intake, which reflects the variety of foods consumed has been recommended to assuage nutritional problems related to insufficient micronutrients, and food insecurity. To better understand the underlying factors for poor birth outcomes in Ghana, we assessed factors associated with dietary diversity among rural and urban pregnant adolescents in the Ashanti Region of Ghana.MethodsAs part of a larger longitudinal cohort of 416 pregnant adolescents, the FAO minimum dietary diversity for women index was used to determine the dietary diversity score (DDS) of the participants from a previous days’ 24-hour dietary recall data. The household hunger scale (HHS) and lived poverty index (LPI) were used to determine hunger and socioeconomic status. Eating behavior and socio-demographic data were gathered using interviewer-administered questionnaires.ResultsThe mean age of the participants was 17.5 (±1.4) years with an MDD-W of 4.4 and 56% recording inadequate MDD score. More rural (63.6%) than urban dwellers (50.6%) had inadequate DDS (p = 0.008). Among all the multiple variables tests of associations on dietary diversity, only hunger status (p = 0.028) and both food aversion and poverty status (p = 0.003) had a significant effect on the adolescents’ dietary diversity. Rural dwelling adolescents (AOR = 1.7, p = 0.035, 95% CI = 1.0–2.6) recorded higher odds for inadequate DD compared with the urban respondents. Pregnant adolescents with severe hunger had higher odds (Unadjusted OR = 1.9, p = 0.053, 95% CI 1.1–3.8) for inadequate dietary diversity compared with those with no hunger.ConclusionsInadequate DD is common among pregnant adolescents in this study and is associated with rural living, food insecurity, poverty, and food craving. Livelihood support for pregnant teenagers and nutrition education are recommended interventions to improve dietary quality and limit the consequences of poor dietary diversity.

Adolescent pregnancy is associated with adverse birth outcomes. However, the determinants of these outcomes are understudied. The present study sought to identify the predictors of adverse birth outcomes among pregnant adolescents in Ghana. In this prospective health centre-based study, 416 pregnant adolescents, aged 13–19 years old, were followed, and 270 birth outcomes were evaluated. We collected data on socio-demographic variables, eating behaviour, household hunger scale (HHS), lived poverty index (LPI) and compliance to antenatal interventions. The prevalence of low birth weight (LBW) and preterm births (PTB) were 15⋅2 and 12⋅5 %, respectively. Pregnant adolescents with no formal education (AOR 9⋅0; P = 0⋅004; 95 % CI 2⋅1, 39⋅8), those who experienced illness (AOR 3⋅0; P = 0⋅011; 95 % CI 1⋅3, 7⋅0), those who experienced hunger (OR 2⋅9; P = 0⋅010; 95 % CI 1⋅3, 6⋅5) and those with high LPI (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅2, 5⋅3) presented increased odds of delivering preterm babies compared with those who have had secondary education, did not experience any illness, were not hungry or having low LPI, respectively. Pregnant adolescents who used insecticide-treated net (ITN) (AOR 0⋅4; P = 0⋅013; 95 % CI 0⋅2, 0⋅9) presented reduced odds LBW children; while those who experienced illness (AOR 2⋅7; P = 0⋅020; 95 % CI 1⋅2, 6⋅0), poorer pregnant adolescents (OR 2⋅5; P = 0⋅014; 95 % CI 1⋅1, 4⋅8) and those who experienced hunger (AOR 3⋅0; P = 0⋅028; 95 % CI 1⋅1, 8⋅1) presented increased odds of LBW children compared with those who used ITN, were not ill, were not poor or did not experience hunger. Adverse birth outcomes were associated with ANC compliance and socioeconomic factors of the pregnant adolescents. Hence, strengthening antenatal uptake and compliance by pregnant adolescents, promoting their livelihood and socioeconomic status, and interventions to prevent teenage pregnancies are strongly recommended.

Background Iron Deficiency Anaemia (IDA) is reportedly high in pregnant adults and the causes well studied. However, among pregnant teenagers, the levels and associated factors of IDA are not fully understood. Methods In a prospective cohort study among Ghanaian pregnant teenagers, aged 13–19 years, IDA prevalence and associated factors were investigated. Sociodemographic data, household hunger scale (HHS), lived poverty index (LPI), FAO’s women’s dietary diversity score (WDDS) and interventions received during antenatal care (ANC) were obtained from 416 pregnant teenagers in Ashanti Region, Ghana. Micronutrient intakes using a repeated 24-hour dietary recall, and mid-upper arm circumference (MUAC) were determined and blood samples analysed for haemoglobin (Hb), serum levels of ferritin, prealbumin, vitamin A, total antioxidant capacity (TAC), C-reactive protein (CRP), and zinc protoporphyrin (ZPP). Results Anaemia (Hb cutoff Conclusions IDA is common among pregnant teenagers and the related factors include malaria tablets given at ANC, maternal hunger, maternal MUAC, a deficient systemic supply of iron, depleted body iron stores, ZPP, and ZPP/Hb ratio. Appropriate interventions are urgently needed to address the causes of IDA among pregnant teenagers.

Background: Inadequate nutritional status during pregnancy can lead to adverse birth outcomes but this is more so for pregnant adolescents as they require nutrients to meet their needs for growth and that of the foetus. The study examined the relationship between nutritional status and birth outcomes among Ghanaian teenagers in rural and urban districts of the Ashanti Region, Ghana.Methods In this prospective cohort study, 416 pregnant teenagers recruited at hospitals/health centres during antenatal care were followed until delivery. Data on weight, height (for body mass index), mid-upper arm circumference (MUAC), and nutrients intake using a repeated 24-hour dietary recall were determined. Blood samples were also taken and analysed for haemoglobin (Hb), serum levels of ferritin, prealbumin, vitamin A, total antioxidant capacity (TAC), C-reactive protein (CRP), and zinc protoporphyrin (ZPP). Birth weight, gestational age at birth, type of delivery, and outcome of delivery were collected as each teenager gave birth. Data were analysed using Chi-square (Fisher’s exact) analysis, t-test, two-way ANOVA and multiple linear regression. Results: 15.9% had low birth weight, 12.5% had preterm birth, 11.5% had a postpartum haemorrhage, and 3.1% neonatal deaths. Majority of the participants had inadequate intakes of energy (81.4%), protein (77.2%), vitamins A (97.1%) and E (97.7%), calcium (99.8%), iron (97.6%), folate (93.0%), zinc (83.7%), riboflavin (88.4%), thiamin (74.4%), and fiber (74.4%) intakes. Anaemia and wasting prevalence were 57.1% and 27.8%. Between-subject effects determined using Generalized Linear Modelling indicated MUAC (p=0.058), and gestational age at delivery (p=0.023) significantly affected birth weight. A multiple linear regression analysis indicated MUAC (β=0.283, p=0.002), BMI (β=0.221, p=0.015), gestational age (β=0.285, p2=1.941).Conclusions: Inadequate nutrients intake, anaemia, and LBW were found in these pregnant teenagers. Maternal MUAC, gestational age, and serum ZPP were associated with birth weight. Interventions for improving the nutritional status of teenagers before and during pregnancy are urgently needed to reduce the risk of adverse birth outcomes.

Inadequate nutrition during pregnancy can lead to adverse birth outcomes, and more importantly for pregnant adolescents as they require nutrients to meet their needs for their growth and the fetus. The study examined the relationship between nutritional status and birth outcomes among Ghanaian pregnant adolescents in selected districts of the Ashanti Region, Ghana. In this prospective cohort study, we followed 416 pregnant teenagers recruited at health centers during antenatal care until delivery. We measured weight and height to calculate Body Mass Index (BMI), and Mid-Upper Arm Circumference (MUAC), and nutrient intakes using a repeated 24 hr dietary recall were collected. Hemoglobin (Hb), serum levels of ferritin, prealbumin, vitamin A, Total Antioxidant Capacity (TAC), C-reactive protein (CRP), and Zinc Protoporphyrin (ZPP) were analyzed. Birth outcome data of interest were low birth weight (LBW) and preterm births (PTB). About 15.2 % had LBW, 12.5 % had PTB, and 3.1 % neonatal deaths. The majority of the pregnant adolescents consumed below Estimated Average Requirements (EAR) for thiamin (75.7 %), riboflavin (84.6 %), folate (82.9 %), vitamin A (87.3 %), iron (93.5 %), zinc (83.7 %), and calcium (96.9 %) intakes, while energy (96.6 %), protein (84.6 %), and dietary fiber (74.4 %) were below the Recommended Dietary Allowance (RDA). Anemia and wasting prevalences were 57.1 % and 27.8 %. The mean intakes for carbohydrates (p = 0.042) and dietary fiber (p = 0.012) were significantly higher among adolescent mothers with term birth (276.7 ± 111.2 g, 23.7 ± 11.2 g) than those with PTB (237.3 ± 83.7 g, 19.4 ± 9.0 g), respectively. Preterm birth proportions were higher in severely wasted (18.8 %) adolescents than moderately wasted (6.2 %) and normal MUAC (14.0 %) adolescents (p = 0.184). LBW proportions were higher among anemic (18.1 %) than the non-anemic (12.1 %), among low (30 %) compared with normal (14.9 %) serum ferritin, among low (15.7 %) compared with normal (0 %) serum prealbumin, and among low (16.2 %) compared with normal (11.1 %) serum vitamin A status pregnant adolescents. Pregnant adolescents with moderate wasting had lower odds (Adjusted odds ratio = 0.2, p = 0.017, 95 % confidence interval = 0.1–0.8) of having LBW infants compared with those with normal MUAC. The odds of preterm births were significantly higher among pregnant adolescents with dietary fiber intake below the RDA (Unadjusted OR = 2.8, p = 0.042, 95 % CI = 1.0–7.3). In conclusion, adverse birth outcomes were associated with poor nutritional status among pregnant adolescents studied.

Background. Dyslipidemia and hypertension are the leading causes of morbidity and mortality in patients with cardiovascular diseases (CVDs). Objective. The study sought to evaluate the effects of Borassus aethiopum-fortified bread on metabolic risk factors among CVD outpatients. Method. From August 2016 to April 2017, a pilot study using a single-blinded randomized placebo-controlled trial was conducted by administering Borassus-fortified bread (150 g) and indistinguishable placebo (150 g white flour bread) daily to 122 CVD outpatients at 37 Military Hospital, Accra, Ghana, for 90 days. Body composition, blood pressure, and biochemical parameters were evaluated before and after the intervention. Results. Following the intervention, the mean waist circumference (before: 98.3±14.6 cm, after: 95.9±15.8 cm, P=0.030), BMI (before: 31.4±6.9 kg/m2, after: 28.0±5.8 kg/m2, P=0.027), and visceral fat (before: 10.4±3.2, after: 9.9±3.0, P=0.013), as well as systolic (from 161.2±25.5 to 137.6±22.9and diastolic (from 99.2±13.6 to 85.1±10.8) blood pressure, were significantly reduced among the experimental group. Likewise, serum total cholesterol (TC), LDL, and HDL were significantly reduced within the experimental group before (TC: 5.9±1.1, LDL: 3.4±1.1, and HDL: 2.2±0.5) and after the intervention (TC: 4.9±1.1, LDL: 2.8±0.9, and HDL: 1.5±0.4) (TC: P=0.001, LDL: P=0.016, and HDL: P < 0.001, in mmol/L). These reductions were not observed in the controls. Conclusion. The Borassus-fortified bread significantly reduced blood pressure and improved lipid profile and other metabolic risk factors among the CVD outpatients studied. Therefore, its potential in the management of CVDs and other metabolic-related diseases should be looked at.

Soups are major components of Ghanaian dishes. The composite nature of Ghanaian soups, in general, tend to make the calorie and macronutrient composition highly variable. This study sought to determine the proximate composition of selected Ghanaian soups from defined recipes and to photographically present quantities of the soups, measured with common Ghanaian household food measures, equivalent to servings of protein and carbohydrates. Two types of each conveniently selected soup (light soup, groundnut soup, kontomire (cocoyam leaves) soup and palm nut soup) were prepared; one with animal protein and the other without. The soups prepared include; LS1- light soup with garden eggplant (African eggplant); LS2- light soup with garden eggplant and chicken GS1- groundnut (peanut butter) soup without animal protein; GS2- groundnutsoup with chicken; PS1- palm nut soup without animal protein; PS2- palm nut soup with smoked catfish and herrings. Proximate analysis was done to determine macronutrient content of all the soups. Each soup was measured using a household food measure (150 ml soup ladle) to obtain a 15 g carbohydrate and 7 g protein equivalent and then photographed. Carbohydrate content of the soups ranged between 1.18 g-8.43 g, proteinwas between 0.34 g-4.31 g and 0.14 g-7.78 g for fat per 100 g of edible portion. Palm nut soup with animal source protein had the highest carbohydrate (8.43 ± 0.86 g) and fibre (1.99 ±0.22 g) content. Soups with the highest protein and fat content were GS2 (4.29 ± 0.14 g) and PS1 (20.39 ± 3.54 g) respectively. Serving sizes of the soups prepared ranged approximately between 1-8½ soup ladles (using 150 ml soup ladle) per 15 gcarbohydrate equivalence and 1-13 soup ladles (using 150 ml soup ladle) per 7 g protein equivalence. It took variable quantities of the prepared soups to obtain the target serving sizes with PS2 having the least quantity (~1 soup ladle) for 15 g carbohydrate serving and PS1 having the least amount (~1 soup ladle) for 7 g protein serving. The large serving size of most of the soups required to meet a serving of protein implied that those soups should be eaten together with food sources rich in protein, in order to appreciably enhance the protein intake of individuals. Key words: Composite Ghanaian soups, serving size, protein, carbohydrates, fats, proximate composition

Purpose In Ghana, the body mass index (BMI) is widely used in clinical practice in assessing weight status, but it is limited as a measure of adiposity. The purpose of this study was to compare bioelectrical impedance analysis (BIA) and body mass index (BMI) methods in determining obesity among some Ghanaians. Design/methodology/approach This was a cross-sectional survey involving 134 participants whose BMI were determined. Percentage body fat mass (%BF) and percentage visceral fat (%VF) were obtained by BIA using a hand-to-hand Omron body composition monitor with a weighing scale. Findings Based on the WHO BMI criteria, 6.0 per cent of the participants were obese. However, according to BIA 18.7 and 20.9 per cent of the participants were obese according to % BF and %VF, respectively. The BMI and %BF showed higher prevalence of obesity among female participants (8.2 and 34.4 per cent, respectively) than male participants (4.1 and 5.5 per cent, respectively), whereas for %VF, obesity was higher among male participants than female participants (26.0 per cent, 14.8 per cent). There was significant positive correlation between BMI and % BF (r = 0.604, p = 0.001); and between BMI and %VF (r = 0.555, p = 0.001). Research limitations/implications There are discrepancies in the prevalence of obesity in the study population as measured by BMI and BIA methods. This suggests that the BMI and BIA may not be reliable tools for assessing obesity in this population. Further studies are needed to determine the cut-offs for BMI and BIA that are associated with metabolic risk in the population. The small sample size limits the generalizability of findings of this study. Originality/value Body composition tends to vary by ethnicity and race; hence, it is essential to determine the appropriate tool for assessing adiposity in African populations for prompt and targeted interventions.

Diabetes mellitus is associated with hyperglycemia, which promotes oxidative stress through production of free radicals which may lead to diabetic complications such as cardiovascular diseases. However,it is proposed that dietary intakes of antioxidant micronutrients may help reduce oxidative stress in diabetes mellitus. The objective was to evaluate the protective effects of antioxidant micronutrients against CVD risk among type 2 diabetics. Method: A systematic literature review including detailed search strategy was developed to search PubMed, PMC, PLOSONE, Google scholar and cochrane. Research articles were retrieved, screened and relevant articles were extracted. The exposure for review were zinc, vitamin E, and selenium, whereas measured outcomes were effects of antioxidant micronutrients on type 2 diabetes: reduced FBG and HbA1c, reduced lipidemia, improved antioxidant status, reduced oxidative stress. Results: Among six cross-sectional studies; five studies indicated serum zinc were significantly reduced in type 2 diabetics than controls, whereas one study showed a higher serum selenium in type 2 diabetics than controls. Among five case-control studies used, two studies found serum zinc was lowered among type 2 diabetics than controls. Another study found serum vitamin E was reduced in type 2 diabetics than controls (p

Dyslipidemia and hypertension are leading causes of morbidity and mortality in cardiovascular diseases (CVDs) patients. Borassus aetiopium is a common tropical fruit in Ghana, with health benefits, as it contains phytochemicals; flavonoids, alkaloid, triterpenes, steroids and sterols, cardiac