Emerging Early Actions to Bend the Curve in Sub-Saharan Africa's Nutrition Transition.

BACKGROUND: Sub-Saharan Africa is the last region to undergo a nutrition transition and can still avoid its adverse health outcomes. OBJECTIVE: The article explores emerging responses to "bend the curve" in sub-Saharan Africa's nutrition transition to steer public health outcomes onto a healthier trajectory. METHODS: Early responses in 3 countries at different stages of food system transformation are examined: South Africa-advanced, Ghana-intermediate, and Uganda-early. By comparing these with international experience, actions are proposed to influence nutrition and public health trajectories as Africa's food systems undergo rapid structural change. RESULTS: Arising from rapid urbanization and diet change, major public health problems associated with overweight are taking place, particularly in South Africa and among adult women. However, public health responses are generally tepid in sub-Saharan Africa. Only in South Africa have policy makers instituted extensive actions to combat overweight and associated noncommunicable diseases through regulation, education, and public health programs. Elsewhere, in countries in the early and middle stages of transition, public health systems continue to focus their limited resources primarily on undernutrition. Related pressures on the supply side of Africa's food systems are emerging that also need to be addressed. CONCLUSIONS: Three types of intervention appear most feasible: maternal and child health programs to simultaneously address short-term undernutrition problems while at the same time helping to reduce future tendencies toward overweigh; regulatory and fiscal actions to limit access to unhealthy foods; and modernization of Africa's agrifood food system through job skills training, marketing reforms, and food industry entrepreneurship.

Potential contribution of mangoes to reduction of vitamin A deficiency in Kenya.

The ß-carotene content of fresh and dried mangoes commonly consumed in Kenya was evaluated and converted to retinol equivalent (RE). Mango fruits of varieties Ngowe, Apple, and Tommy Atkins were harvested at mature green, partially ripe, and ripe stages and their ß-carotene content analyzed. The stability of ß-carotene in sun dried mangoes was also studied over 6 months under usual marketing conditions used in Kenya. The effect of using simple pretreatment methods prior to drying of mango slices on retention of ß-carotene was as well evaluated. In amounts acceptable to children and women, fresh and dried mangoes can supply 50% or more of the daily required retinol equivalent for children and women. Stage of ripeness, variety, postharvest holding temperature, method of drying, and storage time of dried mango slices affected ß-carotene content and consequently vitamin A value of the fruits. Apple variety grown in Machakos had the highest ß-carotene. It exceeded the daily RE requirements by 11.8% and 21.5% for women and children respectively. Fresh or dried mangoes are a significant provitamin A source and should be included in food-based approaches aiming to reduce vitamin A deficiency.