Relationship between dietary patterns and stunting in preschool children: a cohort analysis from Kwale, Kenya.

OBJECTIVES: Stunting is a significant cause of poor cognitive performance and lower school achievement. Stunting is observed among pre-school children in several areas in Africa; however, not all children are affected, and children with and without stunting are seen in the same communities. Therefore, this study aimed to identify nutritional and other factors that prevent stunting that may exist in local communities. STUDY DESIGN: This is a prospective cohort study. METHODS: Data were extracted from the Health and Demographic Surveillance System conducted in Kwale County, Kenya. The cohort consisted of all households with children less than five years old, within a radius of 2.2 km from a local health centre. A dietary pattern (DP) survey with a semi-quantitative food frequency questionnaire was conducted on caretakers of children who were voluntary participated from the cohort between June 2012 and August 2012. Using cluster analysis, the children were assigned to a DP group. Logistic regression analysis was applied to calculate the adjusted odds ratios (aORs) of DPs for stunting controlling for other factors. RESULTS: In total, 402 children were included in the analysis. By cluster analysis, three DPs were identified: protein-rich DP; traditional DP; and traditional DP complemented by breastfeeding. The aOR of a child becoming stunted from a normal height during the study period among children who received a traditional DP compared with those who had a protein-rich DP was 2.78 (95% confidence interval [CI]: 1.02-7.55). However, the aOR for children who were already stunted at the start of the study and had a traditional DP was 1.49 (95% CI: 0.82-2.72). Increased aORs of stunting were observed among children aged over 12 months compared with children aged 6-11 months, and the effects of DPs were modified by age in months from 12 to 35 months; however, the effects were near the null value for children over 36 months of age, although these were not statistically significant. CONCLUSIONS: We found that the traditional DP showed a higher risk for stunting compared with the protein-rich DP, and the most vulnerable age range for stunting was between 12 and 35 months. Interventions to prevent stunting should focus on providing 12- to 35-month-old children with locally available, protein-rich foods.

Post-prandial glucose levels and consumption of omega 3 fatty acids and saturated fats among two rural populations in Kenya.

BACKGROUND: Amount and quality of dietary fat modifies glucose tolerance. Omega 3 Fatty Acids (n-3F A) are polyunsaturated fats, mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found primarily in fish and they have a positive effect on glucose tolerance. OBJECTIVE: To compare risk of type 2 diabetes mellitus (T2DM), as demonstrated thourough impaired glucose tolerance (IGT), and n-3FA intake among two rural populations. DESIGN: A descriptive, cross-sectional comparative study. SETTING: Bondo District (Luo Community) and Kericho District (Kipsigis Community) of the Lake Victoria basin of Kenya. SUBJECTS: Sample of 150 individuals, aged above 18 years was randomly selected from each of the two communities. INTERVENTIONS: Impaired glucose tolerance (IGT) was measured according to World Health Organisation diagnostic criteria. The intake of n-3FA was determined using a 24 hour dietary recall and food frequency schedule. Data was analysed using SPSS and Pearson Correlation Coefficient was used to test correlation between n-3FA consumption and IGT. The inter-group comparisons were done using the t-test and analysis of variance. RESULTS: The prevalence of IGT was 11.8% among the Kipsigis and 4.8% among the Luo (P<0.001). The mean EPA and DHA intake was found to be 0.29 g/day and 0.34 g/day respectively among the Luo and 0.01 g/day and 0.01 g/day among the Kipsigis (P<0.001). The relationship between 2 hour post-prandial glucose level and consumption of DHA was (r=-0.111, p<0.05), EPA (r=-0.123, p<0.05), polyunsaturated fatty acids (r=-0.128, p<0.05) and saturated fats (r=-0.002, p=0.973). CONCLUSION: The levels of IGT were significantly lower (P<0.001) among the Luo, than among the Kipsigis. There was also evidence of significant inverse relationship between IGT and consumption of n-3FA and polyunsaturated fatty acids (PUFA) but no association between saturated fats intake and IGT. The saturated fat ingested did not affect the level of post-prandial glucose. The Luo who consumed higher n-3FA amounts, recorded lower levels of IGT than the Kipsigis who had significantly lower consumption. RECOMMENDATIONS: Effective screening methods should be used at the existing health units to determine risk factors of type 2 diabetes mellitus like IGT among patients. This could help in advising them accordingly on lifestyle changes, especially concerning diet and beneficial fats.