The Association of General and Central Obesity with Dietary Patterns and Socioeconomic Status in Adult Women in Botswana.

Dietary patterns and their association with general and central obesity among adult women were studied using a cross-sectional survey with multistage cluster sampling in urban and rural areas nationwide in Botswana. The participants in the study were adult women (N = 1019), 18-75 years old. The dietary patterns were identified using principal component analysis, and their associations with the body mass index and the weight-for-height ratio were examined. Factor analysis with varimax rotation was used to identify six dietary patterns (fast foods, refined carbohydrates, vegetables and fruits, fish and nuts, Botswana traditional foods, and organ and red meat dietary pattern). Overall, 24.5% of the women were overweight (BMI 25.0-29.99 kg/m2) and 24.5% were obese (BMI > 30 kg/m2). A waist-to-height ratio greater than 0.5 was observed for 42.2% of the women. With adjustment for age and education, individuals in the highest tertile of the Botswana traditional food pattern had a significantly higher risk of general obesity (RR = 1.40, 95% CI: 1.07-1.84) and central obesity (RR = 1.20, 95% CI: 0.97-1.48). With respect to the fish and nut pattern, a significant association was observed with central obesity only (RR = 1.43, 95% CI: 1.18-1.72). The Botswana traditional food pattern, characterised by a high carbohydrate intake, was found to be associated with a high risk of obesity in this study. However, more research is required to assess other factors contributing to obesity in women so that appropriate intervention programs can be put in place to help control this epidemic.

Potential contribution of African green leafy vegetables and maize porridge composite meals to iron and zinc nutrition.

OBJECTIVES: The aim of this study was to determine the mineral nutritive value of different traditional African green leafy vegetable (GLV) dishes and their composite meals with fortified and unfortified maize porridge. METHODS: The mineral (iron, zinc, and calcium) and antinutrient (phytate, total phenolics, and tannins) contents and in vitro bioaccessibility of iron and zinc were analyzed. The iron and zinc contents and bioaccessibilities were used to calculate contribution these dishes and meals could make toward the recommended daily requirements and absolute requirements of vulnerable populations. RESULTS: It was found that the GLV dishes contained average amounts of zinc (2.8-3.2 mg/100 g, dry base [db]), but were high in both iron (12.5-23.4 mg/100 g, db) and antinutrients (phytate 1420-2089 mg/100 g, db; condensed tannins 105-203 mg/100 g, db). The iron bioaccessibility and amount of bioaccessible iron ranged between 6.7% and 45.2% and 0.9 and 5.11 mg/100 g, db, respectively. The zinc bioaccessibility and amount of bioaccessible zinc ranged between 6.4% and 12.7% and 0.63 and 1.63 mg/100 g, db, respectively. CONCLUSION: Importantly, although compositing the GLV dishes with fortified maize porridges decreases the iron and zinc contents, because of the low antinutrient content of the maize meal, the amount of bioaccessible iron and zinc in the meal increases.

The efficacy of micronutrient-fortified sorghum meal in improving the immune status of HIV-positive adults.

BACKGROUND: Micronutrient deficiencies are common and compound the effects of human immunodeficiency virus (HIV) infection in Africa. Nutritional interventions, particularly vitamin A supplementation, may improve immune functioning and delay disease progression. AIM: To investigate the effect of fortified sorghum meal provided for 12 months on the immune status of adults with HIV. METHODS: HIV-infected men and women were enrolled in a double-blind randomized placebo-controlled trial in Kanye, Botswana, to receive either sorghum meal fortified with micronutrients including vitamin A (n = 67) or control (n = 65). Serum retinol, iron, zinc, albumin, CD4 cell count and HIV viral load were assessed at baseline and every 3 months. RESULTS: Baseline serum retinol levels were 1.6 µmol/l in both groups and no significant difference was observed at the end of the intervention (control group: 1.5 µmol/l; experimental group: 1.6 µmol/l). In addition, there was no significant difference in the mean (Q1, Q3) CD4 cell count; 348 (220, 456) cells/mm(3) for the control group versus 338 (228, 426) cells/mm(3) in the experimental group after intervention. CONCLUSION: In this study, fortified sorghum meal did not influence serum retinol, CD4 cell count and HIV viral load. Future intervention studies should carefully consider the composition and dosing of food supplements needed to improve immune status and delay disease progression.

Validation and reproducibility of an FFQ for use among adults in Botswana.

OBJECTIVE: To evaluate the validity and reproducibility of a 122-item interviewer administered quantitative FFQ developed to determine food and nutrient intakes of adults in Botswana. DESIGN: Relative validity of the FFQ was evaluated by comparing nutrient and food group intakes against four non-consecutive 24 h recalls administered over 12 months. The FFQ was repeated after 1 year to assess reproducibility. SETTING: Kanye, Botswana. SUBJECTS: Seventy-nine adults aged 18­75 years. RESULTS: Spearman correlation coefficients for the validity of energy-adjusted nutrients ranged from 0.42 (carbohydrate) to 0.49 (protein) for macronutrients and from 0.23 (Fe) to 0.44 (PUFA) for micronutrients. Exact agreement of quartile distribution for nutrients between the FFQ and recalls ranged from 27% to 72%. Weighted kappa values were lowest for retinol (0.13), Fe (0.22) and b-carotene (0.25) and ranged from 0.33 (SFA) to 0.59 (folate) for other nutrients (energy, carbohydrate, protein, fat, Ca and vitamin E). Spearman correlation coefficients between the recalls and FFQ for food groups ranged from 0.18 (dark green leafy and yellow vegetables) to 0.58 (poultry). Reproducibility correlation coefficients (energy-adjusted) varied between 0.39 for retinol and 0.66 for vitamin E, with most values falling between 0.50 and 0.60. CONCLUSIONS: The FFQ had good relative validity for estimating habitual food group and nutrient intakes, but was poor for some micronutrients (Fe, retinol and b-carotene) and foods (fruits and dark green leafy vegetables).