RESUMEN
Objectives: The Ministry of Health in conjunction with several stakeholders conducted a nationally representative 24-hour dietary recall component of the Kenya National Micronutrient Survey (KNMS) to characterize the average intake and dietary pattern of women of reproductive age and children 7-59 months. Methods: 296 clusters were randomly selected for the KNMS survey. Within each cluster, we randomly selected 2 households that met the inclusion criteria of having either a women of reproductive age, a child under five years of age or both, who are usual residents of the household. An interactive 24-hr recall multiple pass approach was used to collect one day dietary intake data on all households and repeated on a sub-set of 20% households on non-consecutive days. Using PC-SIDE software (version 1.0, June 2013) for data analysis, we determined the usual intake of each nutrient. We report here the dietary data of 399 women (15-49 years) 55 children (7-12 months) and 214 children (13-59 months). Results: Average energy, iron, vitamin A and zinc intakes in women were 1944 kcal, 12.6 mg, 778 μg and 8.1 mg respectively while these nutrient intakes in children 7-12 months and 13-59 months were 473 Kcal, 2.5 mg, 126 μg, 2.1mg and 1036 kcal, 6.3 mg, 366 μg, 4.3 mg respectively. Prevalence of inadequacy among women, children 7-12 months and children 13-59 months using EAR cutoffs and adjusting for intra individual variability was 17%, 94% and 9% for iron; 43%, 99% and 41% for vitamin A; 49%, 62% and 23% for zinc respectively. Conclusions: These data point towards a number of programmatic interventions to improve the adequacy of diets for Kenyan women and children.
RESUMEN
Objectives: Reliance on respondents’ individual recall ability for accurate dietary data collection is always a challenge. We developed a photo atlas to aid respondents in recall of foods eaten during the interactive 24 hr recall multiple pass approach for data collection during the Kenya National Micronutrient Survey 2011. Photographs of foods are preferred for estimating portion sizes because the amount eaten is easier for the respondent to visualize. However, it was necessary to validate the photo atlas before using it. Methods: Seven common Kenyan food items were chosen for validation of the atlas: cassava root, tomatoes, eggplant, raw chicken wings and legs, watermelon and fried dough. Each color photo displayed three differently sizes of each food item to capture “large,” “medium,” and “small”. Actual food portions were used for comparison with the photos. Volunteers were asked to rate the level of similarity between the actual-life food item and the item in the photograph on a scale of 1 to 5. Five indicated “Perfect Match” and one indicated “Not a Match.” 84 volunteers from KEMRI and Kibera were conveniently selected for the validation exercise. Results: Exact matches were highly observed in all sizes of whole foods (onions (52.4; 61.9%; 59%), tomatoes (59.5%; 58.3%; 63.1%) and eggplants 35.7%; 27.4% and 63.1%) compared to sliced food items. No significant differences observed between female and male matches of food items. Conclusions: Identification of difficult to recall foods can be presented as food albums and used as dietary data collection tools.