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Objective: We wanted to identify factors related to dietary behavioural change among impoverished pregnant women in the face of nutrition education and counselling, describing what creates an enabling environment and barriers for dietary change., Design: We used qualitative data from a cluster-randomised maternal education trial and conducted a thematic analysis using a social ecological framework to describe the factors that influenced dietary adherence., Setting: Mangochi district in rural Malawi., Participants: We interviewed ten pregnant women and conducted four sets of focus group discussions with twenty-two significant family members (husbands and mothers-in-law) and twelve counsellors., Results: The participants' experiences showed that the main barriers of adherence to the intervention were taste, affordability and poverty. The use of powders and one-pot dishes, inclusion of both women and significant family members and a harmonisation with local food practices enabled adherence to the intervention. We found it crucial to focus the dietary education and counselling intervention on locally available ingredients and food processing methods., Conclusions: Use of contextualised food-based solutions to combat maternal malnutrition was observed to be relatively cheap and sustainable. However, there is need for more research on local foods used as nutrition supplements. We suggest that investments need to be directed not only to nutrition education and counselling but also to the enabling factors that enhance adherence. The original cluster-randomised controlled trial was registered with Clinical trials.gov ID: NCT03136393.

Recent human cohort studies reported positive associations between organic food consumption and a lower incidence of obesity, cancer, and several other diseases. However, there are very few animal and human dietary intervention studies that provide supporting evidence or a mechanistic understanding of these associations. Here we report results from a two-generation, dietary intervention study with male Wistar rats to identify the effects of feeds made from organic and conventional crops on growth, hormonal, and immune system parameters that are known to affect the risk of a number of chronic, non-communicable diseases in animals and humans. A 2 × 2 factorial design was used to separate the effects of contrasting crop protection methods (use or non-use of synthetic chemical pesticides) and fertilizers (mineral nitrogen, phosphorus and potassium (NPK) fertilizers vs. manure use) applied in conventional and organic crop production. Conventional, pesticide-based crop protection resulted in significantly lower fiber, polyphenol, flavonoid, and lutein, but higher lipid, aldicarb, and diquat concentrations in animal feeds. Conventional, mineral NPK-based fertilization resulted in significantly lower polyphenol, but higher cadmium and protein concentrations in feeds. Feed composition differences resulting from the use of pesticides and/or mineral NPK-fertilizer had a significant effect on feed intake, weight gain, plasma hormone, and immunoglobulin concentrations, and lymphocyte proliferation in both generations of rats and in the second generation also on the body weight at weaning. Results suggest that relatively small changes in dietary intakes of (a) protein, lipids, and fiber, (b) toxic and/or endocrine-disrupting pesticides and metals, and (c) polyphenols and other antioxidants (resulting from pesticide and/or mineral NPK-fertilizer use) had complex and often interactive effects on endocrine, immune systems and growth parameters in rats. However, the physiological responses to contrasting feed composition/intake profiles differed substantially between the first and second generations of rats. This may indicate epigenetic programming and/or the generation of "adaptive" phenotypes and should be investigated further.

Objective: To examine if increased intake of locally available nutrient-dense foods among pregnant women improved the quality of their dietary intake and if use of the Theory of Planned Behaviour could explain changes in their dietary behaviour., Design: We used data from a randomised controlled trial where the intervention group received nutrition education and dietary counselling. We promoted the use of recipes that utilised powders to enhance dietary diversity. We examined how the intervention achieved changes in dietary intakes and used mixed effects logistic regression models with random effects at village level to explore changes over time of the outcomes, adjusted for selected explanatory variables., Setting: The study was conducted in twenty villages in rural Malawi., Participants: Data from 257 pregnant women who were enrolled during late first trimester and followed until birth., Results: The intervention achieved improvements in the Dietary Diversity Score (DDS) and the Six Food Group Pyramid (SFG) score, especially in intakes of micronutrient-rich foods. A third of the women in the intervention group attained optimal DDS, whereas about 50 % attained optimal SFG. The theorised behaviour mediators (i.e. nutrition attitudes, nutrition behaviour control and subjective norm) that had improved were also significantly associated with high DDS., Conclusions: Improved dietary intakes were achieved through promoting the use of locally available nutrient-dense foods. Attainment of high DDS was a consequence of the women's belief in the effectiveness of the proposed nutrition recommendations. We identified critical personal and environmental constraints related to dietary intakes during pregnancy in a low-resource setting.

Background: The major landslide of 2010 in Bududa district in Eastern Uganda is the most catastrophic natural disaster in Uganda's recorded history. An estimated 350 people died and some of the affected were resettled in Kiryandongo district. We assessed housing, water and sanitation practises of affected households and controls to establish possible implications on food insecurity and diet diversity., Methods: This cross-sectional study assessed 1078 affected and control households in Bududa and Kiryandongo districts. The head of the households were either affected, selected from landslide disaster-affected communities, or controls from a random sub-county bordering the affected. Structured interviews were used and entries were tested statistically to report crude estimates based on the Pearson x 2 and ANOVA, while adjusted analysis used multivariate analysis of co-variance (MANCOVA) and Wald's Odds Ratio (OR) of Binary Logistic Regression at the 95% CI., Results: On adjusting for the disaster and covariates, households who had insufficient access to water scored higher mean (SE) on food insecurity than those who reported sufficient access: 13.1 (0.4) vs. 9.5 (0.3) (P < 0.01). Intriguingly, households who owned a toilet and those who reported always using soap to wash hands scored higher food insecurity than their counterparts: 11.1 (0.3) vs. 9.0 (0.6) (P < 0.01) and 11.3 (0.3) vs. 9.1 (0.5) (P < 0.01), respectively. However, not owning a toilet increased the likelihood of being food insecure (OR 3.43; 95% CI 1.31, 8.97; P = 0.02). In Kiryandongo, affected households scored higher food insecurity than controls: 9.5 (0.5) vs. 5.4 (0.5) (P < 0.01) and higher diet diversity scores (DDS): 6.7 (0.2) vs. 6.2 (0.2) (P = 0.04). Type of housing also predicted food insecurity (P < 0.01) and DDS (P = 0.03). Like Bududa, households with insufficient water access scored higher food insecurity while those owning toilet scored higher DDS. Uniquely, only number of rooms was linked to a high likelihood of being food insecure (OR 1.60; 95% CI 1.19, 2.15; P < 0.05)., Conclusion: Disaster, food security and diet were sensitive to housing, water and sanitation and were integral to an adequate standard of living of victims of this landslide., (Copyright © 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.)

Background & Aims: Malnutrition is widespread among disadvantaged people in low-income countries like Uganda. Children and adolescents living in children's homes are considered an especially vulnerable group, and malnutrition among girls is of particular concern since it has intergenerational consequences. Virtually no information exists about the nutritional status of adolescent girls living in children's homes in Uganda. We therefore conducted a cross-sectional study to assess the nutritional status by evaluating anthropometric indicators, body composition and dietary patterns., Methods: Forty-four girls aged 10-19 years living in five children's homes participated in addition to a reference group of 27 adolescent girls from three boarding schools; both in the Ugandan capital Kampala. Height and weight were measured to assess anthropometry. Body composition data was obtained by bioelectrical impedance analysis. Dietary intake was evaluated with a food frequency questionnaire, calculation of dietary diversity score, and a 24-h dietary recall., Results: The adolescent girls living in children's homes suffered from stunting (18.6%), overweight or obesity (18.6%), and were at risk of insufficient intakes of multiple micronutrients, especially of vitamins A, B 12 , C, D, E and calcium. They also had a low intake of essential fatty acids. Dietary diversity was low with a median score of 3 out of 9 food groups. Animal products were rarely consumed., Conclusions: The majority of girls in children's homes consumed a less adequate diet compared to the reference group, thus being at risk of nutrient deficiency-related disorders., (Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

Background: In developing countries like Uganda, the human right to adequate food (RtAF) is inextricably linked to access to land for households to feed themselves directly through production or means for its procurement. Whether RtAF is enjoyed among Ugandan land evictees, is unknown. We therefore explored this among land evictees (rights-holders) in Wakiso and Mpigi districts in rural Central Uganda. We assessed food accessibility and related coping strategies, diet quality and nutritional status of children 6-59 months old, and their caregivers. Effectiveness of the complaint and redress mechanisms in addressing RtAF violations was also explored., Methods: In this cross-sectional study, quantitative data was collected using a structured questionnaire, with food security and nutritional assessment methods from a total of 215 land evictees including 187 children aged 6-59 months. Qualitative data was collected by reviewing selected national and international documents on the RtAF and key informant interviews with 15 purposively sampled duty-bearers. These included individuals or representatives of the Uganda Human Rights Commission, Resident District Commissioner, Sub-county Chiefs, and local Council leaders., Results: We found that 78% of land evictees had insufficient access to food while 69.4% had consumed a less diversified diet. A majority of evictees (85.2%) relied on borrowing food or help from others to cope with food shortages. Of the 187 children assessed, 9.6% were wasted, 18.2% were underweight and 34.2% were stunted. Small, but significant associations, were found between food accessibility, diet quality, food insecurity coping strategies; and the nutritional status of evictees. We observed that administrative, quasi-judicial and judicial mechanisms to provide adequate legal remedies regarding violations of the RtAF among evictees in Uganda are in place, but not effective in doing so., Conclusion: Land eviction without adequate legal remedies is a contributor to food insecurity and undernutrition in rural Central Uganda. It is essential that the Government strengthens and enforces the policy and legal environment to ensure adequate and timely compensation of evictees in order to reduce their vulnerability to food insecurity.

Objectives: Patients with Crohn's disease (CD) often report food hypersensitivities with gastrointestinal (GI) symptoms despite being in clinical remission. We aimed to identify the most frequent symptoms and dietary triggers in such patients, and also explored whether a strict elimination diet may reduce their GI symptoms., Methods: We assessed GI symptoms and dietary triggers in 16 patients with CD in clinical remission. Of these, 12 patients subsequently participated in a dietary intervention trial: two weeks on a habitual diet including wheat and dairy products followed by two weeks of a strict elimination diet. The severity of seven symptoms (overall symptoms, abdominal pain, bloating, abnormal feces, wind, fatigue, and musculoskeletal pain) was measured by using visual analog scales throughout the four weeks intervention period., Main Results: The most common symptoms were abdominal pain, wind, bloating, odorous wind/feces, and diarrhea. Dairy and wheat products were reported as the most frequent dietary symptom triggers. All symptoms improved (p < .05) during the elimination diet period, especially in patients with small intestinal affection., Conclusion: Our exploratory study suggests that dietary interventions such as an elimination diet may reduce GI symptoms in patients with CD in remission.

Objective: To examine the effect of a nutrition and hygiene education intervention on oral health behaviour and whether early onset of caries was related to child growth in rural Uganda., Methods: Follow-up study of a cluster-randomised controlled trial conducted between October 2013 and January 2015. Data were available from 399 mother/child pairs (203 in the intervention and 198 in the control group) of the original trial (78%) when the children were 36 months old. Oral health behaviour was evaluated using questionnaires. Photographs of the maxillary anterior teeth were examined for unmistakably carious lesions, and 115 water samples from the study area were analysed for fluoride concentration., Results: The frequency of cleaning of the child's teeth at 36 months was about twice as high in the intervention as in the control group (84.3% vs. 46.6%; P = 0.0001). Cavitated carious lesions occurred more frequently in the control than the intervention group (27.8% vs. 18.2%; P = 0.04). Extraction of 'false teeth' (ebiino), a painful and crude traditional operation, was profoundly reduced in the intervention group (8.9% vs. 24.7%; P = 0.001). There was no evidence of association between the occurrence of caries and child growth., Conclusions: The education intervention improved oral hygiene practices and reduced the development and progression of caries and extraction of ebiino. Early childhood caries was not clearly associated with child growth., (© 2018 John Wiley & Sons Ltd.)

In low-resource settings, such as rural Malawi, pregnant women are prone to energy and micronutrient deficiencies with the consequence of delivering low-birth weight infants with higher risks of morbidity and mortality. This study aimed to examine the association between maternal dietary intakes during pregnancy and infant birth size. Dietary intakes of 203 pregnant women were assessed between 28 and 35 weeks of gestation and their infants' (n = 132) birth size measured. Intakes of energy, macronutrients, and 11 micronutrients were estimated using a 3-day interactive 24-hr diet recall. Semiquantitative data on food intakes for four additional days were also collected to assess food patterns. Using multilevel linear regression modeling, maternal intakes of carbohydrate were negatively associated with neonate length (β: -0.1; 95% CI: -0.2, 0.0 cm/E%) and abdominal circumference (β: -0.1, 95% CI: -0.2, 0.0 cm/E%), whereas intakes of fat were positively associated with neonate length (β: 0.1; 95% CI: 0.0, 0.2 cm/E%) and abdominal circumference (β: 0.1; 95% CI: 0.0, 0.2 cm/E%). Vitamin C intakes were positively associated with birth weight (β: 1.4; 95% CI: 0.5, 2.3 g/mg). The frequency of milk intake was positively associated with birth weight (β: 75.3; 95% CI: 13.6, 137.0 g/day). These findings offer practical suggestions for food-based interventions in the study area to promote inclusion of fat, vitamin C-rich foods, and milk in pregnancy., (© 2017 John Wiley & Sons Ltd.)

Background: More than 14 % of Ugandan children are orphaned and many live in children's homes. Ugandan authorities have targeted adolescent girls as a priority group for nutrition interventions as safeguarding nutritional health before pregnancy can reduce the chance of passing on malnutrition to the offspring and thus future generations. Ugandan authorities have obligations under international human rights law to progressively realise the rights to adequate food, health and care for all Ugandan children. Two objectives guided this study in children's homes: (a) To examine female adolescent residents' experiences, attitudes and views regarding: (i) eating patterns and food, (ii) health conditions, and (iii) care practices; and (b) to consider if the conditions in the homes comply with human rights standards and principles for the promotion of the rights to adequate food, health and care., Methods: A human rights-based approach guided the planning and conduct of this study. Five children's homes in Kampala were included where focus group discussions were held with girls aged 12-14 and 15-17 years. These discussions were analysed through a phenomenological approach. The conditions of food, health and care as experienced by the girls, were compared with international standards for the realisation of the human rights to adequate food, health and care., Results: Food, health and care conditions varied greatly across the five homes. In some of these the girls consumed only one meal per day and had no access to clean drinking water, soap, toilet paper and sanitary napkins. The realisation of the right to adequate food for the girls was not met in three homes, the realisation of the right to health was not met in two homes, and the realisation of the right to care was not met in one home., Conclusions: In three of the selected children's homes human rights standards for food, health or care were not met. Care in the children's homes was an important contributing factor for whether standards for the rights to adequate food and health were met.

In 2010, a landslide in Bududa, Eastern Uganda, killed about 350 people and nearly 1000 affected households were resettled in Kiryandongo, Western Uganda. A cross-sectional survey assessed household food insecurity and diet diversity among 1078 affected and controls. In Bududa, the affected had a lower adjusted mean score of food insecurity than controls - 9·2 (se 0·4) v. 12·3 (se 0·4) (P<0·01)--but higher diet diversity score (DDS) - 7·1 (se 0·1) v. 5·9 (se 0·1) (P<0·01). On controlling for disaster and covariates, recipients of relief food had higher food insecurity - 12·0 (se 0·6) v. 10·4 (se 0·3) (P=0·02)--whereas farmers had higher DDS - 6·6 (se 0·2) v. 5·6 (se 0·3) (P<0·01). Household size increased the likelihood of food insecurity (OR 1·15; 95% CI 1·00, 1·32; P<0·05) but reduced DDS (OR 0·93; 95% CI 0·87, <1·00; P=0·04). Low DDS was more likely in disaster affected (OR 4·22; 95% CI 2·65, 6·72; P<0·01) and farmers (OR 2·52; 95% CI 1·37, 4·64; P<0·01). In Kiryandongo, affected households had higher food insecurity - 12·3 (se 0·8) v. 2·6 (se 0·8) (P<0·01)--but lower DDS - 5·8 (se 0·3) v. 7·0 (se 0·3) (P=0·02). The latter reduced with increased age (OR 0·99; 95% CI 0·97, 1·00; P<0·05), lowest education (OR 0·54; 95% CI 0·31, 0·93; P=0·03), farmers (OR 0·59; 95 % CI 0·35, 0·98; P=0·04) and asset ownership (OR 0·56; 95% CI 0·39, 0·81; P<0·01). Addressing social protection could mitigate food insecurity.

Background & Aim: The optimal diet for type III hyperlipoproteinemia is unknown. We examined blood lipids and body weight following low or high glycemic index diets in comparison with a lipid-lowering diet., Materials and Methods: Sixteen overweight/obese men completed a cross-over study where they followed a standard lipid-lowering diet, a high and a low glycemic index diet, each lasting 4 weeks. Measurements were obtained at the end of each diet intervention., Results: The lipid-lowering diet reduced significantly LDL cholesterol, and apolipoprotein B by 24%, and 17%, whereas high glycemic index increased LDL cholesterol with 21%. The low glycemic index diet reduced (p<0.05) total and LDL cholesterol and apolipoprotein B compared with the lipid-lowering diet. A moderate weight loss (p<0.05) was achieved after the lipid-lowering diet compared with baseline: 1.4 (-3.6-0.2; median, 95% CI) kg and similar to that after high glycemic index diet. A low glycemic index diet resulted in 2.4 (-3.9-1.4) kg weight loss compared with the high glycemic index diet (p<0.05)., Conclusion: A low glycemic index diet may be superior to that of a standard lipid-lowering diet in type III hyperlipoproteinemia.

Objective: Ketogenic diets like the modified Atkins diet (MAD) are increasingly used in patients with refractory epilepsy. For epilepsy patients, stress is a well‐known seizure‐precipitating factor. New possibilities for measuring biomarkers of stress are now available. The purpose of this study was to investigate the impact of MAD on endocrine stress biomarkers. Methods: Forty‐nine patients with drug‐resistant epilepsy were investigated at baseline and after 12 weeks on MAD. Cortisol and cortisol‐binding globulin (CBG) were measured and free cortisol index (FCI) calculated. We also measured metanephrine, normetanephrine, and methoxytyramine, all markers of epinephrine, norepinephrine, and dopamine, respectively. Changes were analyzed according to sex and antiseizure medications. The different markers at baseline and after 12 weeks of MAD treatment were correlated with seizure frequency and weight loss, respectively. Results: The change in total cortisol was modest after 12 weeks on the diet (from 432.9 nmol/L (403.1–462.7)) to 422.6 nmol/L (384.6–461.0), P = 0.6). FCI was reduced (from 0.39 (0.36–0.42) to 0.34 (0.31–0.36), P = 0.001). CBG increased during the study (from 1126.4 nmol/L (1074.5–1178.3) to 1272.5 nmol/L (1206.3–1338.7), P < 0.001). There were no changes in the metanephrines after 12 weeks on the diet. The decrease in FCI was significant only in women, and only observed in patients using nonenzyme‐inducing ASMs. We did not find any correlation between cortisol, CBG, or FCI levels and seizure frequency. Significance: After being on MAD for 12 weeks, FCI decreased significantly. The reduction in FCI may reflect reduced stress, but it may also be an effect of increased CBG. The reasons behind these alterations are unknown. Possibly, the changes may be a result of a reduction in insulin resistance and thyroid hormone levels. Treatment with MAD does not seem to influence "fight or flight" hormones. [ABSTRACT FROM AUTHOR]

Ketogenic diet, a high‐fat, low‐carbohydrate diet, is an established treatment for patients with severe epilepsy. We have previously reported a moderate reduction in seizure frequency after treatment with a modified Atkins diet. This study aimed to see whether dietary therapy impacts patients' health‐related quality of life (HRQOL). In a randomized controlled design, we compared the change in self‐reported HRQOL among adults with difficult‐to‐treat epilepsy after a 12‐week diet intervention. Thirty‐nine patients with drug‐resistant focal epilepsy (age = 16–65 years) were randomized to eat a modified Atkins diet with maximum 16 g of carbohydrate per day (diet group, n = 19) or to continue eating habitual diet (control group, n = 20). No changes to the other epilepsy treatments were allowed. Patient‐reported HRQOL was assessed with the Quality of Life in Epilepsy Inventory‐89 (QOLIE‐89). The diet group experienced a statistically significant improvement in mean total score of QOLIE‐89 of 10 points compared to controls (p =.002). Moreover, although not statistically significant when using a cutoff of 50% seizure reduction, our data suggest an association between diet‐induced reduction in seizure frequency and improvement in HRQOL. The improvement in HRQOL was not associated with diet‐induced weight reduction. [ABSTRACT FROM AUTHOR]

Water, being an essential nutrient, is crucial for all life. Adequate maintenance of body water compartments is required for optimal fluid balance, which is a prerequisite for cellular homeostasis and blood pressure regulation. Water balance is the result of dietary intake of both fluids and foods as well as metabolically produced water, excretion from the kidneys and losses from other sources (e.g. sweat and feces). The water content in food items varies considerably and ranges from about 5% in nuts to 90% in many fruits and vegetables. Intake of drinking water and beverages also provides varying amounts of water. In everyday life assessment of water balance (i.e. hydration status) is challenging as clinical observations are inaccurate. There is no data regarding drinking water intake in the Nordic or Baltic countries. Keywords: water, fluids, beverages, hydration, recommendations [ABSTRACT FROM AUTHOR]

Background Observational studies have linked pesticide exposure to various diseases, whereas organic food consumption has been associated with positive health outcomes. Organic farming standards prohibit the use of most pesticides, and organic food consumption may therefore reduce pesticide exposure. Objectives To determine the effects of diet (Western compared with Mediterranean) and food type (conventional compared with organic) and sex on urinary pesticide residue excretion (UPRE), as well as associations between specific diet components and UPRE. Methods In this 2-wk, randomized dietary intervention trial, healthy adults were randomly allocated to an intervention (n  = 13) or conventional (n  = 14) group. Whereas participants in the intervention group consumed a Mediterranean diet (MedDiet) made entirely from organic foods, the conventional group consumed a MedDiet made entirely from conventional foods. Both groups consumed habitual Western diets made from conventional foods before and after the 2-wk intervention period. The primary outcome was UPRE. In addition, we assessed diet composition and pesticide residue profiles in foods eaten. Participants were aware of group assignment, but the study assessors were not. Results During the intervention period, total UPRE was 91% lower with organic (mean 17 μg/d; 95% CI: 15, 19) than with conventional (mean 180 μg/d; 95% CI: 153, 208) food consumption (P  < 0.0001). In the conventional group, switching from the habitual Western diet to the MedDiet increased insecticide excretion from 7 to 25 μg/d (P  < 0.0001), organophosphate excretion from 5 to 19 μg/d (P  < 0.0001), and pyrethroid residue excretion from 2.0 to 4.5 μg/d (P  < 0.0001). Small but significant effects of sex were detected for chlormequat, herbicide, and total pesticide residue excretion. Conclusions Changing from a habitual Western diet to a MedDiet was associated with increased insecticide, organophosphate, and pyrethroid exposure, whereas organic food consumption reduced exposure to all groups of synthetic chemical pesticides. This may explain the positive health outcomes linked to organic food consumption in observational studies. This trial was registered at www.clinicaltrials.gov as NCT03254537. [ABSTRACT FROM AUTHOR]

Objective: To assess the association between dietary diversity and development among children under 24 months in rural Uganda and to establish other factors that could be associated with development among these children.Design: A secondary data analysis of a cluster-randomised controlled maternal education trial (n 511) was conducted on a sub-sample of 385 children. We used adjusted ORs (AORs) to assess the associations of dietary diversity scores (DDS) and other baseline factors assessed at 6-8 months with child development domains (communication, fine motor, gross motor, personal-social and problem solving) at 20-24 months of age.Setting: Rural areas in Kabale and Kisoro districts of south-western Uganda.Participants: Children under 24 months.Results: After multivariable analysis, DDS at 6-8 months were positively associated with normal fine motor skills development at 20-24 months (AOR = 1·18; 95 % CI 1·01, 1·37; P = 0·02). No significant association was found between DDS and other development domains. Children who were not ill at 6-8 months had higher odds of developing normal communication (AOR = 1·73; 95 % CI 1·08, 2·77) and gross motor (AOR = 1·91; 95 % CI 1·09, 3·36) skills than sick children. Girls had lower odds of developing normal gross motor skills compared with boys (AOR = 0·58; 95 % CI 0·33, 0·98). Maternal/caregiver nutritional education intervention was positively associated with development of gross motor, fine motor and problem-solving skills (P-values < 0·05).Conclusions: We found an association between child DDS at 6-8 months and improvement in fine motor skills development at 20-24 months. Child illness status, maternal/caregiver nutritional education intervention and sex were other significant baseline predictors of child development at 20-24 months. [ABSTRACT FROM AUTHOR]

Natural and human induced disasters are a threat to food security, economic progress and livelihoods in Uganda. However, we have limited knowledge regarding the putative role of the human rights dimension to the impact and management of such tragedies. In this article we assessed the present policies, legislation and institutional capabilities to ascertain whether they could assure the right to adequate food during disaster situations in Uganda. Using purposive sampling, 52 duty bearers working in institutions deemed relevant to food security, nutrition and disaster management were interviewed using a semi-structured guide. Relevant provisions from policy, legislation, institutional budgets and records of Parliament provided the context for analysis. The most important concern coming from the analyses of the information retrieved were inadequate preparedness mechanisms and capabilities. Whereas Uganda’s Constitution proclaims the right to adequate food, and the need to establish a contingencies fund and commission responsible for disaster preparedness and management, they had not been instituted. Implementation of relevant policies appeared slow, especially with regard to assuring adequate relief food as a State obligation. Legislation to guarantee funding and institutionalisation of necessary disaster preparedness and management capabilities was not in place. An ambitious 5-year Uganda Nutrition Action Plan adopted in 2011 had not yet been funded by mid-2013, implying a reality gap in nutrition programming. Budget architecture and financing to disaster management have in effect fallen short of assuring adequate relief food as a human right. Due to capacity constraints, an approach of humanitarian relief may be entrenched in contradiction of State obligations to respect, protect and fulfil human rights. To stay ahead of the potential threats, the Government with support of the Parliament and relevant partners need to enact legislation to appropriate budget resources needed to institute a mechanism of capabilities to implement the constitutional and policy provisions on the right to adequate food and disaster management. [ABSTRACT FROM AUTHOR]

Abstract: Changes in diet and nutrition, along with other lifestyle changes during the last decades, have affected the nutrition-related disease profile in many developing countries. This phenomenon, or process, is known as ‘The Nutrition Transition’. Several studies on adolescents in South Africa have shown that overweight and obesity are increasing, possibly due to this process. The aim of the present study was to extend our knowledge on the nutrition transition and the factors that influence adolescents’ choice of food in South Africa, and to develop policy recommendations that could facilitate the adolescents’ right to adequate food as laid down in the South African Constitutional Bill of Rights. The data were collected through focus groups with 25 female learners (grade 10, 14–16years) from urban public schools in Cape Town and key informant interviews with 10 school staff members. The most important nutritional concerns that emerged from the analyses, included skipping breakfast and the consumption of unhealthy tuck shop food. In terms of the human right to adequate food, these findings reflected lack of availability and access to adequate food within the household, at schools, and in the community. In addition, the study showed that there were no or few opportunities for physical activity for adolescents during and after school hours. Social factors, including social norms and a need to conform to peer group pressure, appeared to affect the behaviour of learners considerably. Traditional foods appeared to have lost their importance, while learners preferred to consume fast foods and to adopt a more westernised diet connected to affluence and social acceptance. Traditional and more “Western” body perceptions co-existed among the study participants. The nutrition transition in South Africa is of a complex nature because of large differences that exist amongst different ethnic and socioeconomic groups. Policy decisions should be based on an understanding of these diverse factors. The media and the food industry should be encouraged to work with government in influencing adolescents to make healthy food choices. Cultural perceptions which may lead to unhealthy choices and lifestyle need to be addressed while at the same time respecting people’s cultural pride and human dignity. It is recommended that human rights principles are used purposively in the future in policy formulations, interventions, evaluation and monitoring. [Copyright &y& Elsevier]