scholarly journals A six-week healthy eating intervention with family engagement improves food knowledge and preferences but not dietary diversity among urban preschool children in Sri Lanka

2021 ◽  
pp. 1-22
Author(s):  
Fathima Sirasa ◽  
Lana Mitchell ◽  
Aslan Azhar ◽  
Anoma Chandrasekara ◽  
Neil Harris
Keyword(s):  
Sri Lanka ◽  
Nutrition Education ◽  
Healthy Eating ◽  
Child Nutrition ◽  
Dietary Diversity ◽  
Family Engagement ◽  
Food Preferences ◽  
Healthy Food ◽  
Food Knowledge ◽  
The Impact

Abstract Objective: To evaluate the effectiveness of a multicomponent intervention (MCI) on children’s dietary diversity and its impact pathway components of children’s food knowledge and healthy food preferences. Design: A six-week cluster randomised controlled trial with a MCI consisting of child nutrition education plus family engagement, through parental nutrition education, meal preparation and tasting was compared with two groups: single component intervention (SCI) of child nutrition education, and control, conducted during February to July 2018. Preschool centres were randomly assigned to one of the three arms. Children’s food knowledge, healthy food preferences and dietary diversity scores were collected. Intervention effects were analysed using a pre-post analysis and a difference-in-difference model. Setting: Fourteen preschool centres in an urban area of Kurunegala, Sri Lanka Participants: Child-parent dyads of children aged 4-6 years. Final analyses included 306 (for food knowledge and preferences) and 258 (for dietary diversity) dyads. Results: MCI significantly influenced the impact pathways to children’s dietary diversity by increasing children’s food knowledge and healthy food preferences scores by 3.76 and 2.79 (P<0.001) respectively, but not the dietary diversity score (P=0.603), compared to control arm. Relative to SCI, MCI significantly improved children’s food knowledge score by 1.10 (P<0.001), but no significant effects were noted for other outcome variables. Conclusion: Improved food knowledge and preferences require a positive food environment and time to develop into healthy eating behaviours. Research into dietary diversity should broaden to incorporate the contextual roles of the home and general food environments to more completely understand food choices of children.

scholarly journals Cash transfers and child nutritional outcomes: a systematic review and meta-analysis

2020 ◽  
Vol 5 (12) ◽  
pp. e003621
Author(s):  
James Manley ◽  
Yarlini Balarajan ◽  
Shahira Malm ◽  
Luke Harman ◽  
Jessica Owens ◽  
...  
Keyword(s):  
Child Nutrition ◽  
Social Protection ◽  
Dietary Diversity ◽  
Meta Analysis ◽  
Cash Transfer ◽  
Animal Source Foods ◽  
Animal Source ◽  
Z Scores ◽  
Households With Children ◽  
The Impact

BackgroundCash transfer (CT) programmes are implemented widely to alleviate poverty and provide safety nets to vulnerable households with children. However, evidence on the effects of CTs on child health and nutrition outcomes has been mixed. We systematically reviewed evidence of the impact of CTs on child nutritional status and selected proximate determinants.MethodsWe searched articles published between January 1997 and September 2018 using Agris, Econlit, Eldis, IBSS, IDEAS, IFPRI, Google Scholar, PubMed and World Bank databases. We included studies using quantitative impact evaluation methods of CTs with sample sizes over 300, targeted to households with children under 5 years old conducted in countries with gross domestic product per capita below US$10 000 at baseline. We conducted meta-analysis using random-effects models to assess the impact of CT programmes on selected child nutrition outcomes and meta-regression analysis to examine the association of programme characteristics with effect sizes.ResultsOut of 2862 articles identified, 74 articles were eligible for inclusion. We find that CTs have significant effects of 0.03±0.03 on height-for-age z-scores (p<0.03) and a decrease of 2.1% in stunting (95% CI −3.5% to −0.7%); consumption of animal-source foods (4.5%, 95% CI 2.9% to 6.0%); dietary diversity (0.73, 95% CI 0.28 to 1.19) and diarrhoea incidence (−2.7%, 95% CI −5.4% to −0.0%; p<0.05). The effects of CTs on weight-for-age z-scores and wasting were not significant (0.02, 95% CI −0.03 to 0.08; p<0.42) and (1.2%, 95% CI: −0.1% to 2.5%; p<0.07), respectively. We found that specific programme characteristics differentially modified the effect on the nutrition outcomes studied.ConclusionWe found that CT programmes targeted to households with young children improved linear growth and contributed to reduced stunting. We found that the likely pathways were through increased dietary diversity, including through the increased consumption of animal-source foods and reduced incidence of diarrhoea. With heightened interest in nutrition-responsive social protection programmes to improve child nutrition, we make recommendations to inform the design and implementation of future programmes.

scholarly journals Effect of nutrition education on dietary diversity score of type 2 diabetes patients

2020 ◽  
Author(s):  
Robert Mutagwanya ◽  
Christine Magala Nyago ◽  
Fredrick Nelson Nakwagala
Keyword(s):  
Type 2 Diabetes ◽  
Nutrition Education ◽  
Diabetes Management ◽  
Dietary Diversity ◽  
Control Group ◽  
Mulago Hospital ◽  
Diabetic Patients ◽  
The Impact ◽  
Diabetes Patients

Abstract Background: Consumption of a varied diet reduces the risk of developing a deficiency or excess of any one nutrient. One of the three corner stones of diabetes management is diet and therefore, dietary diversity is key among diabetes patients. Objective: The objective of this study was to establish the impact of nutrition education on the dietary diversity scores (DDS) among type 2 diabetes patients. Methods: Kant et al method was used for scoring dietary diversity. Data were analyzed using the statistical package for social sciences (SPSS version 21). Pair sample t-test was used to compare total DDS after and before nutrition education. P< 0.05 was considered as statistically significant.Subjects: One hundred type 2 diabetic patients were randomly selected and divided into two groups of intervention and control (50 patients in each group) to participate in the study. Data were collected using a pre-tested questionnaire before and after intervention every after one month for a period of four months of intervention.Results: The average age of patients who participated in the study was 48 (40–51) years. Most of the patients were females (65.39%), compared to males (34.01%). At the end of the study period of four months, DDS in the control group decreased from 40.08% to 38.49% (p=0.064) while in the intervention group, DDS increased from 35.30 % to 54.20% (p<0.001). Conclusion: Dietary diversity increased after nutrition education among type 2 diabetes patients.Trial registration: The study was registered and approved on 17th April 2013 by the Research and Ethics committee of Mulago Hospital and Institutional Review Board of Mulago hospital (Protocol MREC 113).

scholarly journals Summer Garden Programs Improve Children’s Food Knowledge and Preferences: Evidence Using Stated and Revealed Preference Measures

2016 ◽  
Vol 26 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Joanna Brown ◽  
Gregory Colson ◽  
Claire B. de La Serre ◽  
Nicholas Magnan
Keyword(s):  
Healthy Eating ◽  
Fruits And Vegetables ◽  
Food Preferences ◽  
Revealed Preference ◽  
Healthy Foods ◽  
Community Based ◽  
Plant Knowledge ◽  
Food Knowledge ◽  
Excessive Body Weight ◽  
American Children

One reason for excessive body weight among youth is poor eating choices. Garden-based programs have the potential to educate children about fruits and vegetables and healthy eating generally, and improve their food preferences. This study examines the impacts of two community-based summer garden programs in Atlanta, GA, on children aged 5–14 years (n = 71). These programs spanned 1 to 2 weeks and included daily gardening activities and nutritional education. The study employs a pre- and postprogram questionnaire and a food choice experiment to evaluate changes in knowledge about and preferences for healthy and unhealthy foods. Results show that the programs substantially and significantly increased knowledge about nutrients (P < 0.01), plants (P < 0.1), and healthy foods (P < 0.01). The programs also increased the number of fruits and vegetables participants tried (P < 0.1) and their propensity to make healthy choices in the food experiment (P < 0.1). Regression analysis shows program impacts on plant knowledge (P < 0.1) and fruits and vegetables tried (P < 0.1) to be lower for African American children (n = 38) and all other program impacts to be statistically homogenous. At least in the short term, garden programs such as these can alter children’s preferences and decisions regarding healthy eating. More research is needed to see if these effects persist and ultimately improve health outcomes into adulthood.

scholarly journals Scaled-Up Nutrition Education on Pulse-Cereal Complementary Food Practice in Ethiopia: A Cluster-Randomized Trial

2020 ◽  
Author(s):  
Getenesh Berhanu Teshome ◽  
Susan J. Whiting ◽  
Timothy J. Green ◽  
Demelash Mulualem ◽  
Carol J. Henry
Keyword(s):  
Nutritional Status ◽  
Nutrition Education ◽  
Weight Status ◽  
Dietary Diversity ◽  
Intervention Group ◽  
Complementary Food ◽  
Control Group ◽  
Dietary Diversity Score ◽  
Cluster Randomized ◽  
The Impact

Abstract Background: Improving children's weight status through nutrition education (NE) for mothers about using pulses in complementary feeding has been demonstrated in pilot studies, but no effect on stunting was reported. The aim of the study was to assess the impact of a 9-month pulse-nutrition education program on improving mothers' knowledge, attitude, and practices (KAP) towards pulses, as well as its effect on children's diet diversity, and nutritional status. The NE was delivered by Health Extension Workers (HEWs). Methods: A cluster randomized study was employed for the community-based interventional study. Twelve randomly selected villages in Sidama Zone, Southern Ethiopia were included in the study. A total of 772 mother-child pairs involved in the study; where 386 mother-child pairs in the intervention group received additional messages about pulse-cereal complementary food, and 386 pairs (the control) received only routine health education for 9 months. A survey on mothers’ KAP and anthropometric measurements of the children were taken at baseline, midline, and endline. ANOVA and descriptive statistics were used to analyzed data. Results: At baseline and endline, maternal KAP and the dietary diversity score of the children (mean age at endline 18.8 ± 2.9 mo) were assessed. Intervention mothers’ KAP improved (p<0.001) at midline and endline compared to that of the control group, as did frequency of pulse consumption and Dietary Diversity Score (DDS) among children. At 9 months, the prevalence of stunting, wasting, and underweight was significantly reduced in the intervention group compared to the control group (p=0.001). Conclusions: NE delivered by HEWs improved KAP of mothers regarding pulse consumption and dietary diversity of children led to improved nutritional status of the children. Training HEWs on the use of pulses for complementary food may be an effective way to improve the health of children in Ethiopian communities. Trial Registration: Clinicaltrials.gov #NCT02638571

scholarly journals Community-Level Impacts of Climate-Smart Agriculture Interventions on Food Security and Dietary Diversity in Climate-SMART VILLAGES in Myanmar

Climate ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 166
Author(s):  
Andrew Hanley ◽  
Galina Brychkova ◽  
Wilson John Barbon ◽  
Su Myat Noe ◽  
Chan Myae ◽  
...  
Keyword(s):  
Food Security ◽  
Rural Communities ◽  
Nutrition Education ◽  
Dietary Diversity ◽  
Household Food Security ◽  
Attitudes And Practices ◽  
Trade Offs ◽  
Smart Agriculture ◽  
The Impact ◽  
Knowledge Attitudes And Practices

Diversification of production to strengthen resilience is a key tenet of climate-smart agriculture (CSA), which can help to address the complex vulnerabilities of agriculture-dependent rural communities. In this study, we investigated the relationship between the promotion of different CSA practices across four climate-smart villages (CSVs) in Myanmar. To determine the impact of the CSA practices on livelihoods and health, survey data were collected from agricultural households (n = 527) over three years. Within the time period studied, the results indicate that some the CSA practices and technologies adopted were significantly associated with changes in household dietary diversity scores (HDDS), but, in the short-term, these were not associated with improvements in the households’ food insecurity scores (HFIAS). Based on the survey responses, we examined how pathways of CSA practice adoption tailored to different contexts of Myanmar’s four agroecologies could contribute to the observed changes, including possible resulting trade-offs. We highlight that understanding the impacts of CSA adoption on household food security in CSVs will require longer-term monitoring, as most CSA options are medium- to long-cycle interventions. Our further analysis of knowledge, attitudes and practices (KAPs) amongst the households indicated a poor understanding of the household knowledge, attitudes and practices in relation to nutrition, food choices, food preparation, sanitation and hygiene. Our KAP findings indicate that current nutrition education interventions in the Myanmar CSVs are inadequate and will need further improvement for health and nutrition outcomes from the portfolio of CSA interventions.

Formative Research for an Intervention to Reduce Plate Waste and Improve Produce Intake in Schools

2021 ◽  
Vol 8 (5) ◽  
Author(s):  
Amy Schachtner-Appel ◽  
Nadine Sahyoun ◽  
Jie Chen ◽  
Hee-Jung Song
Keyword(s):  
Nutrition Education ◽  
Child Nutrition ◽  
Eating Behaviors ◽  
Cognitive Theory ◽  
Food System ◽  
Vegetable Intake ◽  
Comparative Method ◽  
Food Preferences ◽  
Formative Research ◽  
Plate Waste

Objective: High plate waste in schools adds social, economic, and environmental burden and undermines child nutrition goals. In this study, we conducted formative research to examine potential for mindful-based approaches in reducing plate waste and improving fruit and vegetable intake. Methods: With a triangulation approach, research was conducted in 3 elementary schools using focus groups with students (N = 50), staff interviews (N = 15), and cafeteria observations (N = 9). Guided by Social Cognitive Theory, qualitative findings were analyzed using Constant Comparative Method. Results: Salient personal, behavioral, and environmental factors potentially contributing to student plate waste and eating behaviors were identified. School meal structure and regulations, cafeteria atmosphere, food quality perceptions, and food preferences were potential contributors to plate waste. Students had limited knowledge of mindfulness and were interested in reducing waste, particularly when others are food-insecure. Emphasizing mindfulness and sustainability in nutrition education, collaborating with parents and student leaders, and building on existing waste reduction initiatives could be considered to reduce plate waste and improve eating behaviors. Conclusions: Findings highlighted opportunities to design a program combining mindfulness and sustainable food system education and cafeteria environment changes to reduce plate waste and improve FV intake and sustainability of school meals.

scholarly journals Participation in a Nutrition Education and Demonstration Program in Rural Senegal Is Associated with Higher Household Dietary Diversity

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 900-900
Author(s):  
Hannah Sanders ◽  
Scott Ickes
Keyword(s):  
Food Insecurity ◽  
Nutrition Education ◽  
Dietary Diversity ◽  
Low Cost ◽  
Program Participation ◽  
Food Groups ◽  
Linear Regression Models ◽  
Demonstration Program ◽  
The Impact ◽  
Household Dietary Diversity

Abstract Objectives We conducted a non-randomized evaluation of a nutrition education program delivered by Soins de Santé Primaire in rural Senegal to identify the impact of participation on household dietary diversity scores (HDDS). We also sought to understand participant's perceptions of program strengths and weaknesses. Women participated in a single education session that emphasized hygiene, selecting from a variety of food groups, risk awareness of diet-related non-communicable diseases, and a recipe demonstration of a locally-sourced, balanced meal. We hypothesized that program participation would be associated with increased HDDS. Methods We surveyed 20 female program participants sampled from two communities and compared their responses with 20 women sampled from two non-intervention communities (n = 40). Surveys collected 24-hour dietary recall to calculate a dietary diversity score using the 12-point HDDS scale. The mean difference in HDDS was evaluated between post-program and comparison groups using linear regression. Models controlled for household size, employment, education, marital status, and the Food Insecurity Experience Scale. We conducted key informant interviews with post-program participants (n = 19) to understand message recall, reported behavior change, and feedback for future sessions. Results Women in intervention households reported higher HDDS than comparison households [Mean (SE) = 9.0 (0.39) vs. 7.65 (0.24), P = .003]. In the adjusted model, program participation was positively associated with HDDS (β = 1.16, P = .041). Household food insecurity was associated with lower HDDS (β = −0.52, P = .024). Program participants recalled the importance of reducing bouillon cube usage and eating from each food group. Participants reported changes in food preparation and hygiene routines, such as adding more beans or vegetables and changing dirty dishwater often. The key improvement suggestion was to increase session frequency and expand education on hygiene and sanitation. Conclusions Low intensity nutrition education programs that include meal demonstrations may be a low-cost, effective method for improving dietary diversity among a population with moderate food insecurity in rural Senegal. Funding Sources World Renew, Services Luthériens pour le Developpement au Sénégal, and the Wheaton Human Needs and Global Resources Program.

scholarly journals Desarrollo de preferencias alimentarias saludables en etapas tempranas de la vida

2020 ◽  
Vol 70 (4) ◽  
Author(s):  
Mónica Mazariegos
Keyword(s):  
Complementary Feeding ◽  
Dietary Diversity ◽  
Food Preferences ◽  
Sweet Taste ◽  
Healthy Food ◽  
Window Of Opportunity ◽  
Eating Patterns ◽  
Postnatal Exposure ◽  
Revisión Sistemática

El deterioro de la calidad de la dieta está afectando la salud de los niños menores de dos años. Por tal motivo, es de vital importancia la identificación de factores relacionados con el desarrollo y establecimiento de preferencias alimentarias en etapas tempranas de la vida y brindar recomendaciones que faciliten su adopción. Esta revisión sistemática de la literatura tiene como objetivo resumir la evidencia existente sobre los factores asociados a formar y modelar las preferencias alimentarias en etapas tempranas de la vida. Para esto se realizó una búsqueda en PubMed de estudios que evaluaran la asociación entre la exposición prenatal y posnatal de sabores, introducción temprana de alimentos y habituación al sabor dulce, alimentación complementaria y diversidad dietética. Se incluyeron artículos publicados desde el 2000 hasta el 2019. Resultados de 39 artículos sugieren que la alimentación durante los primeros dos años de vida y el desarrollo de preferencias alimentarias en etapas tempranas de la vida tiene el potencial de modificar los patrones de alimentación y establecerse en etapas posteriores de la vida, por lo que, los primeros mil días de vida constituyen una ventana de oportunidad para formar preferencias alimentarias saludables y mejorar la calidad de dieta de los niños. Poor diets are damaging children’s health. Therefore, it is urgent to identify factors related to the development and establishment of healthy food preferences early in life and to provide recommendations to enable their adoption. This systematic literature review aims to summarize the existing evidence on the factors identified on shaping food preferences early in life. For this, a search was conducted on PubMed about studies evaluating the association between prenatal and postnatal exposure of flavors and the development of food preferences, early food introduction, innate preference to sweet taste, complementary feeding and dietary diversity with the development of food preferences. Articles published from 2000 to 2019 were included. Results from 39 manuscripts suggest that the first 2 years of life are critical for the development of food preferences early in life. These food preferences have the potential to modify children’s eating patterns and persist later in life. Therefore, the first 1000 days of life are a key window of opportunity to establish healthy food preferences and shape the quality of children’s diet.

Household acquisition of healthy food away from home

2018 ◽  
Vol 120 (3) ◽  
pp. 588-601 ◽  
Author(s):  
Andrea M. Leschewski ◽  
Dave D. Weatherspoon ◽  
Annemarie Kuhns
Keyword(s):  
Nutrition Education ◽  
Healthy Food ◽  
Household Composition ◽  
Dietary Quality ◽  
Content Type ◽  
Information Transparency ◽  
Food Away From Home ◽  
The Uk ◽  
Value Pricing ◽  
The Impact

Purpose The purpose of this paper is to analyze households’ acquisition of healthy food away from home (FAFH) from restaurants. Specifically, determinants of households’ decision to purchase healthy FAFH, the share of households’ FAFH expenditures allocated to healthy FAFH and the share of households’ FAFH calories obtained from healthy items are identified. Design/methodology/approach Using data from the National Household Food Acquisition and Purchase Survey, the UK Food Standards Agency’s Nutrient Profiling Model is used to classify the healthfulness of households’ FAFH purchases. A double-hurdle model is estimated to identify determinants of households’ decision to purchase healthy FAFH and the share of their FAFH expenditures and calories allocated to healthy items. Findings Households’ acquisition of healthy FAFH varies with income, food assistance, FAFH purchase frequency, dieting, restaurant type, household composition, region and season. There is little difference in the impact of these factors on healthy FAFH expenditure shares vs calorie shares, suggesting that healthy FAFH expenditures proxy the contribution of healthy FAFH to a households’ diet. Practical implications Results suggest that increased availability of healthy FAFH may need to be supplemented by targeted advertising and promotions, revisions to nutrition education programs, improved nutrition information transparency and value pricing in order to improve the dietary quality of households’ FAFH acquisitions. Originality/value This study is the first to analyze household acquisition of healthy FAFH.

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