"I thought I was going to die there:" Socio-political contexts and the plight of undocumented Latinx in the COVID-19 pandemic.

Since the beginning of the COVID-19 pandemic, certain U.S. population groups have suffered higher rates of infection and mortality than whites, including Latinx. Public health officials blamed these outcomes on overcrowded housing and work in essential industries prior to the vaccine's availability. We sought to illuminate the lived experience of these factors through a qualitative study of undocumented Latinx immigrant workers in the secondary economy (n â€‹= â€‹34). This study focuses on the intersectionality of social locations for undocumented Latinx immigrants living in a relatively affluent suburb and working in the construction and service sectors prior to the pandemic. Their narratives revealed how the pandemic created financial precarity through prolonged periods of unemployment and food insecurity. Workers described worry over unpaid bills, and potentially catastrophic episodes in which they treated severe COVID-19 with home remedies. Long spells of unemployment, food insecurity, inability to pay bills and lack of access to healthcare emerged because of socio-political contexts including the nature of low-wage labor and lack of a safety net.

Patterns and predictors of elevated blood pressure and hypertension among primary school children in urban Kenya.

OBJECTIVE: We examined the prevalence of elevated blood pressure (BP) and hypertension among 390 primary school children of different socioeconomic status (SES) in two urban settings in Kenya and explored the association between children's BP status and their sociodemographic characteristics, dietary behaviours and overweight/obesity status. METHODS: Children's BP and anthropometric measurements were taken and parents, with the help of their children, completed questionnaires on the children's dietary behaviours. An average of three BP readings was used to calculate BP percentiles by age, sex and height. BMI-for-age z-scores, waist-circumference-to-height ratio and the sum of skinfold measures were calculated. We utilized prevalence ratio analysis to examine the association between BP and sociodemographic characteristics, dietary behaviours and overweight/obesity. RESULTS: About 9% of the school children had elevated BP and 33% had stage 1 hypertension. Among overweight children, the proportion of children with elevated BP was 1.85-fold greater and the proportion of children with hypertension was 1.83-fold greater compared with children with healthy body weight. Similar patterns of significant associations were seen among obese children, children with central obesity and children with high total skinfold values. The proportion of children with hypertension was 1.42-fold greater among children with high frequency of consumption of chips/crisps compared with children with lower frequency of consumption. CONCLUSION: These results increase our understanding BP patterns and determinants among school children in Kenya and can help inform noncommunicable disease prevention efforts.

Food Environment in and around Primary School Children's Schools and Neighborhoods in Two Urban Settings in Kenya.

We conducted a cross-sectional study to provide an overview primary school children food environment in two urban settings in Kenya. Six schools, catering to children from low-, medium- and high-income households in the cities of Nairobi and Kisumu in Kenya, participated in the study. Data on types of food places and foods offered were collected and healthy and unhealthy food availability scores calculated for each place. We utilized prevalence ratio analysis to examine associations between food availability, food place characteristics and neighborhood income levels. Altogether, 508 food places, located within 1 km of the schools and the school children's neighborhoods were observed. Open-air market sellers and kiosks were most common. The proportion of food places with high healthy food availability was 2.2 times greater among food places in Nairobi compared to Kisumu, 1.9 times greater in food places with multiple cashpoints, 1.7 times greater in medium/large sized food places and 1.4 times greater in food places located in high income neighborhoods. These findings highlight differences in availability of healthy foods and unhealthy foods across types of food places and neighborhood income levels and inform public health interventions aimed at promoting healthy food environments in Kenya.

Mothers' beliefs about indigenous and traditional food affordability, availability and taste are significant predictors of indigenous and traditional food consumption among mothers and young children in rural Kenya.

OBJECTIVE: To examine mothers' and young children's consumption of indigenous and traditional foods (ITF), assess mothers' perception of factors that influence ITF consumption, and examine the relationship between perceived factors and ITF consumption. DESIGN: Longitudinal study design across two agricultural seasons. Seven-day FFQ utilized to assess dietary intake. Mothers interviewed to assess their beliefs about amounts of ITF that they or their young children consumed and on factors that influence ITF consumption levels. SETTING: Seme sub-County, Kenya. PARTICIPANTS: Mothers with young children. RESULTS: Less than 60 % of mothers and children consumed ITF at time of assessment. Over 50 % of the mothers reported that their ITF consumption amounts and those of their children were below levels that mothers would have liked for themselves or for their young children. High cost, non-availability and poor taste were top three reasons for low ITF consumption levels. Mothers who identified high cost or non-availability as a reason for low levels of ITF consumption had significantly lower odds of consuming all ITF except amaranth leaves. Mothers who identified poor taste had significantly lower odds of consuming all ITF except green grams and groundnuts. Similar relationships were noted for young children's ITF consumption levels. CONCLUSIONS: A majority of the mothers reported that they and their children did not consume as much ITF as the mothers would have liked. Further studies should examine strategies to improve availability and affordability of ITF, as well as develop recipes that are acceptable to mothers and children.

Maternal knowledge, outcome expectancies and normative beliefs as determinants of cessation of exclusive breastfeeding: a cross-sectional study in rural Kenya.

BACKGROUND: Despite the importance of multiple psychosocial factors on nutrition-related behavior, very few studies have explored beyond the role of mothers' knowledge and perception of child-focused outcomes on the duration of exclusive breastfeeding in Africa. Our objective was to determine the relationships among mothers' knowledge, outcome expectancies, normative beliefs, and cessation of exclusive breastfeeding in rural Kenya. METHODS: A cross-sectional survey was conducted among 400 mothers of children, 0-24 months old, in rural Kenya. Early child-feeding practices, knowledge of breastfeeding recommendations, beliefs associated with impact of exclusive breastfeeding on child- and mother-focused outcomes and perception of acceptability of exclusive breastfeeding by important others were examined. Cox regression analysis was used to assess the relationship between independent variables of interest and cessation of exclusive breastfeeding. RESULTS: Being knowledgeable of breastfeeding-related recommendations, positive beliefs on the impact of exclusive breastfeeding on child- focused outcomes, having a more positive perception of the impact of exclusive breastfeeding on mother-focused outcomes and a more positive perception of acceptability of exclusive breastfeeding by important others were associated with significantly lower risks of premature cessation of exclusive breastfeeding. CONCLUSION: In addition to knowledge levels, mothers' beliefs play an important role in mothers' decisions to practice exclusive breastfeeding. Mother's beliefs on the impact of exclusive breastfeeding on the mother's health, physical appearance and ability to engage in other activities were shown to have the strongest relationship with premature cessation of exclusive breastfeeding. Addressing these beliefs has the potential to contribute to more effective exclusive breastfeeding promotion efforts in rural Kenya.

Distribution and determinants of young child feeding practices in the East African region: demographic health survey data analysis from 2008-2011.

We utilized the most recent Demographic Health Survey data to explore the distribution of feeding practices and examine relationships between complementary feeding and socio-demographic and health behaviour indicators in Kenya, Uganda and Tanzania. We based our analysis on complementary dietary diversity scores calculated for children 6-23 months old. Geographically, Kenya displayed clear division of children's diet diversity scores across its regions, unlike Uganda and Tanzania. Less than 40% of the children's meal frequencies in Uganda and Tanzania had met the minimum daily recommended levels. Only 30-40% of children in Kenya, Tanzania and Uganda had consumed diets with adequate diversity. Children's age, breastfeeding status, mother's education level and working status, household wealth index, prenatal care visits, receiving vitamin A supplements, using modern contraceptives and meal frequencies were significantly associated with adequate complementary food diversity in at least one of the three countries included in the current analyses. These analyses contribute to a better understanding and targeting of infant and young child feeding within the East African region.

Determining minimum food intake amounts for diet diversity scores to maximize associations with nutrient adequacy: an analysis of schoolchildren's diets in rural Kenya.

OBJECTIVE: To explore multiple methods of calculating diet diversity scores (DDS) to maximize associations with predicted dietary micronutrient adequacy among schoolchildren in rural Kenya. DESIGN: Up to three 24 h recall interviews were administered for each child for a total of 1544 d of intake from all schoolchildren. Daily amounts of food consumed were assigned to one of eight food groups. Five DDS were developed based on various minimum intake amounts from each food group: (i) 1 g; (ii) 15 g; (iii) a variable minimum based on the content of a target nutrient for each group; (iv) the median intake level for each group; and (v) the 90th percentile intake level for each group. A diet was assigned 1 point towards the daily DDS if the food group intake was above the defined minimum level. Five scores were calculated for each child, and bivariate longitudinal random-effects models were used to assess the correlation between each DDS and the mean probability of adequacy for fourteen nutrients. SETTING: Embu District, Kenya. SUBJECTS: Schoolchildren (n 529), mean age 7·00 (sd 1·41) years. RESULTS: Only DDS based on a 15 g minimum and DDS based on nutrient content were significantly associated with mean probability of adequacy after adjusting for energy intake (0·21 and 0·41, respectively). CONCLUSIONS: A DDS using minimum intakes based on nutrients contributed by a food group best predicted nutrient adequacy in this population. These analyses contribute to the continued search for simpler and more valid dietary quality indicators among low-income nations.

Fish-enhanced and soybean-enhanced supplemental snacks are acceptable among pregnant women in rural Kenya.

BACKGROUND: Although animal-source foods provide a rich source of complete protein and a variety of micronutrients, a majority of these foods are not accessible to a large proportion of populations in low-income nations. Locally available and affordable nutrient-dense dietary solutions that are accessible all year round can provide the most viable solution to improving food and nutrition security for these vulnerable populations. However, their potential to improve nutritional status among pregnant women has not been documented. OBJECTIVE: The study was conducted to help guide the development of fish-enhanced and soybean-enhanced supplemental snacks and evaluate their acceptability among pregnant women in rural Kenya. METHODS: We developed fish-enhanced and soybean-enhanced snacks using the small local lake fish omena (Rastrineobola argentea) and soybean flour. A cross-sectional study design was used to assess snack acceptance levels among HIV-infected and -noninfected pregnant women, two high-risk groups for nutrient deficiencies. RESULTS: Overall, 96%, 80%, and 81% of participants, indicated that they liked the taste, odor, texture, and color of wheat, fish-enhanced, or soybean-enhanced snacks, respectively. No significant differences were noted across participants' HIV status. Focus group discussions with the women further supported results from the quantitative ratings. CONCLUSIONS: Our analysis demonstrates the feasibility of developing acceptable, nutrient-dense food supplements using locally available foods in rural Kenya and contributes culturally acceptable, affordable, and sustainable solutions to the problem of undernutrition among pregnant women in low-income countries in sub-Saharan Africa.

Meat supplementation increases arm muscle area in Kenyan schoolchildren.

The present study examines the effect of animal-source-food (ASF) intake on arm muscle area growth as part of a larger study examining causal links between ASF intake, growth rate, physical activity, cognitive function and micronutrient status in Kenyan schoolchildren. This randomised, controlled feeding intervention study was designed with three isoenergetic feeding interventions of meat, milk, and plain traditional vegetable stew (githeri), and a control group receiving no snack. A total of twelve elementary schools were randomly assigned to interventions, with three schools per group, and two cohorts of 518 and 392 schoolchildren were enrolled 1 year apart. Children in each cohort were given feedings at school and studied for three school terms per year over 2 years, a total of 9 months per year: cohort I from 1998 to 2000 and cohort II from 1999 to 2001. Food intake was assessed by 24 h recall every 1-2 months and biochemical analysis for micronutrient status conducted annually (in cohort I only). Anthropometric measurements included height, weight, triceps skinfold (TSF) and mid-upper-arm circumference (MUAC). Mid-upper-arm muscle area (MAMA) and mid-upper-arm fat area (MAFA) were calculated. The two cohorts were combined for analyses. The meat group showed the steepest rates of gain in MUAC and MAMA over time, and the milk group showed the next largest significant MUAC and MAMA gain compared with the plain githeri and control groups (P< 0.05). The meat group showed the least increase in TSF and MAFA of all groups. These findings have implications for increasing micronutrient intake and lean body mass in primary schoolchildren consuming vegetarian diets.

A school-based supplementary food programme in rural Kenya did not reduce children's intake at home.

OBJECTIVE: To examine changes in energy intake along with markers of dietary quality (animal-source energy and protein intakes) among household members in the presence of supplementary school feeding in rural Kenya. DESIGN: A 2-year, longitudinal, randomized controlled feeding intervention study. SETTING: Kyeni South Division, Embu District, Kenya. SUBJECTS: A total of 182 schoolchildren and selected household members. RESULTS: There was no evidence that schoolchildren who received supplementary snacks at school experienced reduced intakes at home or that intakes by other family members were increased at the expense of the schoolchild's intake. CONCLUSIONS: This analysis highlights a number of factors useful in planning for supplementary feeding interventions in rural Kenya and similar communities.

Geographic distribution and socio-economic determinants of women's nutritional status in Mali households.

OBJECTIVE: Mali is one of the poorest countries in Africa, with 72% of its population surviving on less than $US 1.00 per day. Health and demographic indicators are bleak. With few exceptions, studies related to the health of women in Mali have largely been under-represented. In addition, in recent years a new type of malnutrition stemming from weight gain and obesity has been observed throughout Africa. The present study aimed to (i) describe geographic and health variations of women of reproductive age, (ii) describe geographic variations of household salt iodine levels and (iii) investigate potential factors associated with women's anthropometric status and use of adequately iodized salt among households in Mali. DESIGN: Demographic and Health Survey data, multistage-stratified cluster sampling methodology. SETTING: Rural and urban areas of Mali. SUBJECTS: Non-pregnant women (n 6015) between the ages of 19 and 44 years. RESULTS: Nineteen per cent of the women were overweight or obese while 11% were underweight. Seventy-eight per cent of the households utilized adequately iodized salt. Underweight women were more prevalent in southern Mali, while obesity was more frequent in the north-east and within the major urban areas. Households located within the southern parts of Mali were more likely to utilize adequately iodized salt. Education, age, modern contraceptive use, breast-feeding status at time of the survey and household wealth index were significantly associated with the women's BMI or households' use of adequately iodized salt. CONCLUSIONS: The combined use of statistical and geographic system analysis contributes to improve targeting of interventions among vulnerable populations.

Maternal-child overweight/obesity and undernutrition in Kenya: a geographic analysis.

OBJECTIVE: The purpose of the study was to examine geographic relationships of nutritional status (BMI), including underweight, overweight and obesity, among Kenyan mothers and children. DESIGN: Spatial relationships were examined concerning BMI of the mothers and BMI-for-age percentiles of their children. These included spatial statistical measures of the clustering of segments of the population, in addition to inspection of co-location of significant clusters. SETTING: Rural and urban areas of Kenya, including the cities of Nairobi and Mombasa, and the Kisumu region. SUBJECTS: Mother-child pairs from Demographic and Health Survey data including 1541 observations in 2003 and 1592 observations in 2009. These mother-child pairs were organized into 399 locational clusters. RESULTS: There is extremely strong evidence that high BMI values exhibit strong spatial clustering. There were co-locations of overweight mothers and overweight children only in the Nairobi region, while both underweight mothers and children tended to cluster in rural areas. In Mombasa clusters of overweight mothers were associated with normal-weight children, while in the Kisumu region clusters of overweight children were associated with normal-weight mothers. CONCLUSIONS: These findings show there is geographic variability as well as some defined patterns concerning the distribution of malnutrition among mothers and children in Kenya, and suggest the need for further geographic analyses concerning the potential factors which influence nutritional status in this population. In addition, the methods used in this research may be easily applied to other Demographic and Health Survey data in order to begin to understand the geographic determinants of health in low-income countries.

Maternal nutrition in rural Kenya: health and socio-demographic determinants and its association with child nutrition.

High levels of food insecurity and human immunodeficiency virus (HIV) infection place most breastfeeding mothers in Kenya at high risk of malnutrition. We examined the role of selected socio-economic, demographic and health factors as determinants of nutritional status among HIV-infected and HIV-uninfected mothers in rural Kenya and further examined the interrelationship between maternal nutritional and child nutritional status within this population. A cross-sectional design was used to collect data from non-pregnant mothers with children ages 4-24 months in Kisumu District, Kenya. Over 80% of the mothers were breastfeeding at the time of the study. Mean maternal body mass index (BMI) (21.60 ± 3.15) and percent body fat (22.29 ± 4.86) values were lower than among lactating mothers in other Sub-Sahara African countries. Maternal HIV status was not significantly associated with any of the maternal nutritional indicators assessed in the study. Breastfeeding, recent severe illness and having multiple children below 2 years of age were negatively associated with maternal nutritional status, while higher maternal age, socio-economic status and household food security were each positively associated with maternal nutritional status. Significant positive association was reported between maternal weight, height, BMI, mid-upper arm circumference (MUAC), body fat and fat-free mass estimates, and children's height-for-age, weight-for-age, weight-for-height and MUAC-for-age z-score. This analysis identifies determinants of maternal nutritional status in rural Kenya and highlights the importance of interventions that address malnutrition in both HIV-infected and HIV-uninfected mothers in rural Kenya. Significant association between maternal and child nutritional status stresses the importance of addressing maternal and young child nutritional status as interrelated factors.

Undernutrition among Kenyan children: contribution of child, maternal and household factors.

OBJECTIVE: To examine the contribution of selected child-, maternal- and household-related factors to child undernutrition across two different age groups of Kenyan under-5s. DESIGN: Demographic and Health Survey data, multistage stratified cluster sampling methodology. SETTING: Rural and urban areas of Kenya. SUBJECTS: A total of 1851 children between the ages of 0 and 24 months and 1942 children between the ages of 25 and 59 months in Kenya. RESULTS: Thirty per cent of the younger children were stunted, 13 % were underweight and 8 % were wasted. Forty per cent of the older children were stunted, 17 % were underweight and 4 % were wasted. Longer breast-feeding duration, small birth size, childhood diarrhoea and/or cough, poor maternal nutritional status and urban residence were associated with higher odds of at least one form of undernutrition, while female gender, large birth size, up-to-date immunization, higher maternal age at first birth, BMI and education level at the time of the survey and higher household wealth were each associated with lower odds of at least one form of undernutrition among Kenyan children. The more proximal child factors had the strongest impact on the younger group of children while the intermediate and more distal maternal and household factors had the strongest impact on child undernutrition among the older group of children. CONCLUSIONS: The present analysis identifies determinants of undernutrition among two age groups of Kenyan pre-school children and demonstrates that the contribution of child, maternal and household factors on children's nutritional status varies with children's age.

Determinants of early child-feeding practices among HIV-infected and noninfected mothers in rural Kenya.

Quantitative and qualitative data were collected from mothers with children aged 4 to 24 months to examine the determinants of child-feeding practices among HIV-infected and noninfected mothers in the rural parts of Kisumu District in Kenya. More than 40% of children had received other foods or drinks by 3 months of age. Home-based births, perceived small child size at birth, and larger household size were associated with significantly higher risks of premature cessation of exclusive breastfeeding. Maternal HIV infection, overweight/obesity, and having multiple "under-2's" were associated with higher risks of overall breastfeeding cessation. Higher socioeconomic status was associated with significantly lower risks of premature cessation of exclusive breastfeeding. Child-feeding decisions were often made postpartum. Mothers were more likely to discuss feeding methods with their partners only if they were HIV infected. Poverty was identified as a barrier to exclusive breastfeeding in the first 6 months.

Childhood overweight and obesity among Kenyan pre-school children: association with maternal and early child nutritional factors.

OBJECTIVE: To report on the prevalence of overweight and obesity among pre-school children in Kenya and examine the associations between childhood overweight and selected maternal and child-related factors. DESIGN: Demographic Health Survey data, multistage stratified cluster sampling methodology. SETTING: Rural and urban areas of Kenya. SUBJECTS: A total of 1495 children between the ages of 3 and 5 years in Kenya. RESULTS: Over 30 % of the children were stunted, approximately 16 % were underweight, 4 % were wasted, approximately 18 % were overweight and 4 % were obese; 8 % were both overweight/obese and stunted. Maternal overweight and obesity, higher levels of maternal education, being a large or very large child at birth, and being stunted were each associated with higher odds of overweight and obesity among Kenyan children. Older children and large household size were each associated with lower odds of overweight and obesity among Kenyan children. CONCLUSIONS: The analysis demonstrates the presence of under- and overnutrition among Kenyan pre-school children and the importance of focusing on expanding efforts to prevent and treat malnutrition within this population. It also identifies some of the modifiable factors that can be targeted in these efforts.

Nutritional assessments of patients with non-alcoholic fatty liver disease.

BACKGROUND: Obesity is not only associated with nonalcoholic fatty liver disease (NAFLD) but it also adversely affects the progression of other liver diseases. There are limited data regarding the dietary habits of patients with chronic liver disease. METHODS: Nutrition surveys containing 13 different food groups were mailed. Nutrition scores were calculated based on weekly servings. Foods were also divided into USDA food pyramid categories with conversion of each group into calories expended. Clinico-demographic data were available. NAFLD patients were compared to patients with chronic viral hepatitis. RESULTS: A total of 233 subjects were included: age 52.5 +/- 10.0 years, Body mass index (BMI) 28.1 +/- 6.5, MS 24.2%, 31.8% NAFLD, 48.1% hepatitis C virus (HCV), and 20.2% hepatitis B virus (HBV). Six nutrition indices were different among the groups. NAFLD and HCV consumed more low-nutrient food (p = 0.0037 and 0.0011) and more high-sodium food than HBV (p = 0.0052 and 0.0161). Multivariate analysis showed that NAFLD and HCV consumed more high-fat sources of meat/protein than HBV (p = 0.0887 and 0.0626). NAFLD patients consumed less calories from fruits compared to HCV and HBV patients (p = 0.0273 and 0.0023). Nine nutrition indices differed according to BMI. Univariate analysis showed that obese/overweight patients consumed more high-fat sources of meat/protein (p = 0.0078 and 0.0149) and more high-sodium foods (p = 0.0089 and 0.0062) compared to the normal-weight patients. In multivariate analysis, normal-weight patients consumed more fruits than obese (p = 0.0307). Overweight patients also consumed more calories of meat and oil than normal-weight patients (p = 0.0185 and 0.0287). CONCLUSION: NAFLD and HCV patients have similar dietary habits. Patients with HBV have the healthiest dietary habits. Specific dietary interventions should focus on decreasing intake of low-nutrient and high-sodium food, as well as high-fat sources of meat/protein.

Dietary micronutrients are associated with higher cognitive function gains among primary school children in rural Kenya.

With the exception of iodine and Fe, there is still very limited information on the effect of micronutrients on cognitive function, especially among school-age children. The present analysis evaluates the relationship between dietary Fe, Zn and B vitamins (B12, B6, folate and riboflavin) and gains in cognitive test scores among school children in rural Kenya. Data for the present study were obtained from The Child Nutrition Kenya Project, a 2-year longitudinal, randomised controlled feeding intervention study using animal source foods. Dietary nutrient values were based on monthly and bimonthly 24 h recall data collected during the study period. In longitudinal regression analyses, available Fe, available Zn, vitamin B12 and riboflavin showed significant relationships with improved cognitive test scores, after controlling for confounders such as energy intake, school, socio-economic status and morbidity. Available Fe intake was associated with significantly higher gains in Raven's Coloured Progressive Matrices test scores over time. Available Zn intake was associated with significantly higher gains in digit span-total test scores over time, while vitamin B12 and riboflavin intakes were each associated with significantly higher gains in digit span-forward test scores over time. This analysis demonstrates the influence of improved dietary micronutrient status on school children's cognitive function.

A comparison of weighed and recalled intakes for schoolchildren and mothers in rural Kenya.

OBJECTIVE: To evaluate the relative validity of recalled intake among schoolchildren and mothers in rural Kenya. DESIGN: Cross-sectional study. Mothers' recall of both the schoolchild's intake and her own intake on the previous day were compared with intakes that were weighed by an interviewer in the home. SETTING: Karurumo location of Embu District in Kenya. SUBJECTS: A total of forty-two sets of grade 1 students and their mothers. RESULTS: Between 08.00 and 17.00 hours, when foods were both weighed and recalled, approximately 70 % of weighed food items were recalled the next day. Under-reporting of food amounts was seen across most food categories for the recall, with added sugars, sweets and fats being most affected. The recall underestimated energy intakes by approximately 6-9 % during this period. Correlation coefficients between nutrient intakes ranged from 0.43 to 0.65, while weighted kappa values ranged from 0.22 to 0.50. Higher levels of agreement were noted for nutrient densities, with correlation coefficients between 0.46 and 0.82 and weighted kappa values between 0.30 and 0.73. CONCLUSIONS: Although the recall method provides an acceptable alternative to the more labour-intensive and expensive food-weighing method, there is need to further improve its performance in this population through more accurate recall of single foods, especially fruits, as well as added sugars, fats, dairy products and meats, which are often added in small amounts to mixed dishes.

Out-of-home food intake is often omitted from mothers' recalls of school children's intake in rural Kenya.

Children often consume foods from outside the home (OH foods), which can decrease the accuracy of dietary recalls collected from the parents. The objectives of this study were to describe the types and composition of OH foods consumed by rural school-aged Kenyan children, to assess their contribution to the daily intake of the child, and to evaluate the ability of the mother to estimate intake of OH foods. To capture any seasonal differences, the study was conducted twice, once during a food shortage season and again during the subsequent harvest season. School children were asked to recall the types and amounts of OH foods consumed on the previous day. Mothers were asked to report on the types and amounts of all foods consumed by their children during the day of interest. OH foods contributed 13 and 19% of daily energy intake in the food shortage and harvest seasons, respectively, but mothers missed 77 and 41% of the OH energy intake. OH foods were most likely to be fruits (guavas, mangoes, and wild fruit) and starchy foods (bread and fried wheat dough). Nutrients most likely to be under-reported on the mothers' recalls were vitamin C (59 and 26% was missed in the food shortage and harvest seasons, respectively) and vitamin A (approximately 22% was missed in both seasons). To ensure that all food intake is recalled, it is important that school children be included in dietary assessment interviews about their own intakes.