Training to Build Nutrition Capacity in the Nigerian Agricultural Sector: Initial Assessment and Future Directions.

BACKGROUND: In response to calls to increase nutrition-sensitive agriculture (NSA), the Federal Ministry of Agriculture and Rural Development developed the Nigeria Agricultural Sector Food Security and Nutrition Strategy 2016-2025 (AFSNS). Capacity development activities to facilitate the AFSNS implementation subsequently commenced. OBJECTIVE: This study analyzed the processes and outputs of initial capacity development efforts, examined findings from the analysis using existing literature, and identified critical next steps for nutrition capacity development in the Nigerian agriculture sector. METHODS: The study reviewed documents including a proposal for nutrition training of agriculture sector actors, reports of meetings held among 6 resource persons who designed and/or delivered training, training reports, participants' pre- and posttraining assessments, and participants' training evaluation. Interviews were conducted with 2 resource persons involved in training design and delivery. Documents and interviews were coded and analyzed to identify emergent themes. Participants' pre- and posttests results were compared using paired t test in Stata 12.0. RESULTS: Knowledge and practice gaps were more extensive than had been anticipated. Training had some but limited effects on knowledge scores at the federal level. Modules addressing implementation practices had to be scaled down for participants to keep up with the learning pace. Existing literature indicates that such training would have been better planned as part of a broader sectoral nutrition workforce strategy, to facilitate greater tailoring of training to participants' job roles. CONCLUSION: Effective AFSNS implementation requires developing and operationalizing a comprehensive short-, medium- and long-term Agriculture Sector Nutrition Capacity Development Strategy for Nigeria.

Evaluation of in vitro and in vivo Glycemic Index of common staples made from varieties of White Yam (Dioscorea rotundata).

Consumption of high Glycemic Index (GI) foods is a risk factor for increasing prevalence of diabetes mellitus (DM). The extent of variation in starch digestibility and GI of Yam varieties and products is not yet fully understood. This study was therefore designed to evaluate in vitro and in vivo Glycemic Index properties of commonly consumed products prepared from varieties of White Yam. Four products (boiled, fried, pounded yam, and Amala) were prepared from 5 common varieties of Yam and evaluated for Digestible Starch (DS) and Resistant Starch (RS). Based on results, two products-pounded yam and Amala-were processed from three of the most popular varieties. Analysis of Rapidly Digestible Starch (RDS), Slowly Digestible Starch (SDS), and estimated in vitro GI (eGI) were then carried out in this stage. Glycemic Index (GI) of these products consumed by apparently healthy young adults were also determined. Variety Amula had highest DS in Amala (19.1/100 g) and pounded Yam (20.4/100 g) while variety Alumaco had highest RS in all the products (2.9-3.3/100 g). When compared with RS in its raw tuber, RS of Alumaco generally increased after processing. Variety Alumaco had lowest RDS in Amala (0.6/100 g) and pounded yam (0.3/100 g) while eGI was lowest in Alumaco made into Amala (53) and pounded yam (48). Assessment of GI resulted in high GI for all products across each variety. Irrespective of variety, processing Yam into Amala released RDS fraction faster when compared with pounded yam. Generally, even though the products are considered as having high GI, Amala raised eGI and GI faster than Pounded yam. Variety-Alumaco particularly showed favorable properties applicable to dietary management of diabetes. Exploring more processing methods and genetic diversity is recommended.

Nutrition-related knowledge, practice, and weight status of patients with chronic diseases attending a district hospital in Nigeria.

Background: Africa is experiencing an epidemic of non-communicable diseases (NCDs), and the projected mortality from NCDs by 2030 will overtake the combined mortality from communicable diseases. Nutrition is a key modality for preventing and treating NCDs, and optimal nutrition knowledge is essential for self-care. Aim: This study assessed the nutritional-related knowledge, dietary practice, and weight status of patients with non-communicable diseases attending State Specialist Hospital, Ring Road, Ibadan, Nigeria. Methods: This hospital-based descriptive cross-sectional study was conducted among 302 adult patients with chronic diseases attending a district hospital in Ibadan, Nigeria. Data were obtained using a semi-structured interviewer's administered questionnaire on sociodemographic, diet-related knowledge and dietary practices, sources of dietary information and body mass index. The knowledge and practice score was calculated, and Chi-squared test was used to evaluate associations between socio-demographics, nutrition-related knowledge and practices; statistical significance was set at P < 0.05. Results: The mean age of respondents was 61.94 ± 10.60, and 74.4% were women. Overall, 61.3% of the respondents had good nutrition knowledge, with a higher proportion among women (61.8%) than men (59.5%). However, more women were overweight (33.2%) or obese (21.7%). There was a significant difference in the knowledge of respondents based on income (P < 0.034), duration of illness (P < 0.012), as well as nutrition practice (P < 0.000). Conclusion: There was a high prevalence of overweight and obesity among the participants despite the overall satisfactory nutritional knowledge. Hence, primary care physicians as frontline doctors coordinating care need to advocate for holistic weight reduction strategies in managing chronic diseases.

Nutrient Intake in Children 4-13 Years Old in Ibadan, Nigeria.

The paucity of adequate data on dietary and nutrient intakes of school-age children is a barrier to addressing malnutrition and associated risks in Nigeria. This study included 955 children aged 4-13 years from Ibadan, Nigeria, using a stratified random sampling design. Information on family socio-demographic characteristics was reported, and child anthropometrics were measured. Dietary intake data were collected using a multi-pass 24 h dietary recall method; 20% of subjects completed a second 24 h recall to estimate usual nutrient intakes. Means and distributions of usual intakes of energy and nutrients as well as prevalence of inadequacy were estimated. Usual energy intake (kcal/day) was 1345 and 1590 for younger (4-8 years) and older (9-13 years) age groups, respectively. The macronutrient intakes of most children did not conform to Adequate Macronutrient Distribution Ranges (AMDRs), which were characterized by a higher proportion of energy from carbohydrates and lower proportion from total fats. Protein intake was largely within the AMDR. Compared to recommendations, over 60% of 4-8-year-old children had inadequate intakes of calcium, copper, iron, folate, and vitamins A, D, and E. There were more micronutrient inadequacies in the older children. This study identifies nutrition gaps and suggests future research and education to improve child nutrition in Nigeria.

Effect of processing and variety on starch digestibility and glycemic index of popular foods made from cassava (Manihot esculenta).

In Sub-Saharan Africa (SSA), the prevalence of diabetes mellitus (DM) is rapidly increasing even in populations with significant undernutrition. The role of energy dense staple crops such as cassava is under query and not yet well understood. In this study, varieties of cassava, made into popular SSA products (fufu and gari dough) were studied for their resistant starch (RS), rapidly digestible starch (RDS) and glycemic index (GI). While the glycemic properties of the varieties studied did not differ significantly, processing any variety into either fufu or gari distinctly impacted RS, RDS and predicted GI (pGI) differently. Specifically, fufu had highest range of RS (1.1-2.1 g/100 g) while gari dough had highest RDS (1.1-1.4 g/100 g) and pGI (54-67). The results from this probe imply that fufu, when consumed, will release glucose in a slower manner than gari, therefore may be better suited in the dietary prevention and management of DM.

The contribution of provitamin A biofortified cassava to vitamin A intake in Nigerian pre-schoolchildren.

Biofortified yellow cassava has been developed to alleviate vitamin A deficiency. We examined the potential contribution of yellow cassava to total retinol activity equivalent (RAE) intake if replacing white by yellow cassava among pre-school Nigerian children. Dietary intake was assessed as part of a randomised controlled trial. Pre-schoolchildren (n 176) were randomly assigned to receive either white cassava (WC) or yellow cassava (YC) for 17 weeks. Dietary intake assessments were conducted during the intervention and 1 month after, when children had resumed their habitual diet. Differences in RAE intake between groups and time points were compared using a linear mixed model regression analysis. During intervention, median RAE intake was 536 µg/d in the YC group and 301 µg/d in the WC group (P < 0·0001). YC contributed approximately 40 % to total RAE intake. Of the children, 9 % in the YC group and 29 % in the WC group had RAE intake below the Estimated Average Requirement. After intervention, median RAE intake was 300 µg/d and did not differ between intervention groups (P = 0·5). The interaction effect of group and time showed a 37 % decrease in RAE intake in the YC group after the intervention (Exp(ß) = 0·63; 95 % CI 0·56, 0·72). If WC was replaced by YC after intervention, the potential contribution of YC to total RAE intake was estimated to be approximately 32 %. YC increased total RAE intake and showed a substantially lower inadequacy of intake. It is therefore recommended as a good source of provitamin A in cassava-consuming regions.

Food Sources of Key Nutrients, Meal and Dietary Patterns among Children Aged 4-13 Years in Ibadan, Nigeria: Findings from the 2019 Kids Nutrition and Health Study.

This study examined the contribution of food to nutrient intake, meal and dietary patterns among children aged 4-8 and 9-13 years in the city of Ibadan, Nigeria. Multi-pass 24-hour dietary recalls were used to assess intakes. Prudent and traditional Southwestern Nigerian dietary patterns were identified among children. The top foods and beverages were defined by frequency and amount consumed. Meal patterns were described by the eating occasions, while cluster analysis probed dietary patterns. About 88% of children had at least three meals including breakfast (95%), lunch (85%), dinner (92%) and midmorning meals (48%), while about 60% ate snacks at least once daily. Sources of energy and key nutrients were limited (yam, cassava, rice, maize, bread and beans/peas/legumes). The amount consumed per consumer of cassava products (192.2, 256.0 g), yam (169.7, 256.0 g), legumes (115.3, 150.7 g), corn/maize (160.4, 195.2), and rice (138.4, 182.3 g) were high, while beef (15.2, 17.9 g), eggs (50.6, 49.2 g), fish (27.5, 30.6 g), milk (24.2, 27.0 g) and nuts and seeds (18.2, 19.7 g) were low for children ages 4-8 and 9-13 years, respectively. In conclusion, while the frequency of meals suggests a healthy pattern, the top foods could not provide adequate nutrient (especially micronutrient) intake, which is key to the development of the target population.

Double Burden of Malnutrition: Evidence from a Selected Nigerian Population.

Indices reflecting the double burden of malnutrition in sub-Saharan Africa are increasing. Evidence to support this claim in households of Africa's most populous country-Nigeria-is scant. This study, therefore, presents results from a study of mother-child pairs sampled from Akwa Ibom State in the southern region of Nigeria. Anthropometric measures for 660 mother-child pairs were collected according to standard procedures. Indices were expressed as the standard deviation of units from the median for the reference group. Chi-square analysis was used to test significant differences in proportion, and p < 0.05 was taken as significant. A total of 37.4% of the children were stunted out of which 19.8% were moderately stunted, and 17.6% were severely stunted. Prevalence of wasting was 13.1%, 6.2% were moderately wasted, and 6.9% were severely wasted. Mean maternal body mass index was (23.54 ± 4.60) kgm2. 9.0% were underweight mothers, 23.2% were overweight, and 9.3% were obese. The co-existence of undernutrition among children and overnutrition in women of child-bearing age is prevalent in this population. We recommend that more effort be placed on active nutrition surveillance to ascertain malnutrition prevalence and periodically reassess priority challenges.

Retention of Pro-Vitamin A Content in Products from New Biofortified Cassava Varieties.

Plant breeding efforts in sub-Saharan Africa (SSA) have produced biofortified cassava with high carotenoid content to address vitamin A deficiencies (VAD). Since carotenoids in foods are easily depleted during processing, the retention of ß-carotene in some newly released cassava varieties is under query. From four of these new varieties, two commonly consumed products (gari and its dough) were processed according to standard methods. Retention of ß-carotene was then probed after applying fermentation periods of a day and three days. The possible contribution of the products to Vitamin A intake in children, adolescents, and women was also assessed. The concentration of ß-carotene in fresh Cassava roots ranged from 5.32 to 7.81 µg/g. The percentage retention ranged from 14.4 to 29.3% and 10 to 21.7% in gari fermented for one and three days respectively. The impact of varietal difference and length of fermentation was significant on retention in the intermediate and final products (p < 0.001). When compared with dietary intake data, cooking biofortified gari into its dough reduced Vitamin A intake in most varieties. We conclude that processing Cassava into gari (especially its dough) could hinder the retention of ß-carotene however some varieties have retention advantage over others irrespective of the initial concentration in their fresh roots.

Does Nutrition Knowledge and Practice of Athletes Translate to Enhanced Athletic Performance? Cross-Sectional Study Amongst Nigerian Undergraduate Athletes.

INTRODUCTION & OBJECTIVES: Nutrition knowledge of an athlete, as well as practice, is expected to influence athlete's performance. The study assessed the nutrition knowledge and practice as well as athletes' performance and identified the factors predicting the athletes' performance. METHODOLOGY: A cross-sectional survey, involved 110 purposively selected undergraduate athletes (47 females, 63 males) of University of Ibadan, Nigeria, between July 2013 and December 2013. A semi-structured, self-administered questionnaire assessed the nutrition knowledge and practice. 24-hr diet recall and food frequency questionnaire were done. Anthropometric measurements were taken; body composition was determined by bioelectrical impedance analysis method. Handgrip strength (HGS), as an indirect measure of athlete performance, was assessed with the hand dynamometer. Chi-square and t-test analysis were used for the bivariate analysis. Pearson correlation and simple linear regression were used to determine relationships and predict athletic performance. The level of statistical significance was p<0.05. RESULTS: More than half (58.2%) had good nutrition knowledge (NK), and 62.7% had good nutrition practices (NP). Majority (75.4%) had normal handgrip strength (HGS). More than 70.0% frequently do not consume cereals, roots and tubers, fruits and vegetables, legumes /nuts. About 30.0-40.0% frequently do not consume eggs/milk, meat/fish. Having good NK was significantly associated with good NP (χ2=15.520, p=0.000), but not with athlete's performance (HGS). There is no significant correlation between NK, NP, and HGS. There is a significant positive correlation between HGS and lean muscle mass (LMM) (r=.670, p=0.000), weight (r=.492, p=0.000), height (r=.521, p=0.000) and energy intake (r=.386, p=0.000). There is a significant negative correlation between HGS and percentage body fat (r=-.400, p=0.000). Athletes' performance was significantly predicted by the resting metabolic rate (beta=.454 C.I=0.011 to 0.045, p=0.003), Lean muscle mass (beta=.297 C.I=.059 to 0.562, p=0.024) and the weight (beta=.228, C.I=1.852 to .489, p=0.047). CONCLUSION: Having good nutrition knowledge or practice did not directly determine athletic performance. However, there is the need for nutrition education interventions, to improve athlete's performance by promoting adequate energy intake, lean muscle mass and appropriate weight gain in athletes.

Cassava Intake and Vitamin A Status among Women and Preschool Children in Akwa-Ibom, Nigeria.

BACKGROUND: As part of the HarvestPlus provitamin A-biofortified cassava program in Nigeria we conducted a survey to determine the cassava intake and prevalence of vitamin A deficiency among children 6-59 months and women of childbearing age in the state of Akwa Ibom. METHODS: A cluster-randomized cross-sectional survey was conducted in 2011 in Akwa Ibom, Nigeria. The usual food and nutrient intakes were estimated using a multi-pass 24-hour recall with repeated recall on a subsample. Blood samples of children and women were collected to analyze for serum retinol, serum ferritin, and acute phase proteins as indicators of infection. Vitamin A deficiency was defined as serum retinol <0.70 µmol/L adjusted for infection. RESULTS: A total of 587 households of a mother-child dyad participated in the dietary intake assessment. Cassava was very widely consumed in Akwa Ibom, mainly as gari or foofoo. Daily cassava consumption frequency was 92% and 95% among children and women, respectively. Mean (±SD) cassava intake (expressed as raw fresh weight) was 348 ± 317 grams/day among children and 940 ± 777 grams/day among women. Intakes of most micronutrients appeared to be adequate with the exception of calcium. Median vitamin A intake was very high both for children (1038 µg RAE/day) and women (2441 µg RAE/day). Red palm oil and dark green leafy vegetables were the main sources of vitamin A in the diet, with red palm oil alone contributing almost 60% of vitamin A intake in women and children. Prevalence of vitamin A deficiency ranged from moderate (16.9 %) among children to virtually non-existent (3.4 %) among women. CONCLUSION: Consumption of cassava and vitamin A intake was high among women and children in Akwa Ibom with a prevalence of vitamin A deficiency ranging from moderate in children to non-existent among women. The provitamin A biofortified cassava and other vitamin A interventions should focus dissemination in states where red palm oil is not widely consumed.

Data collection and assessment of commonly consumed foods and recipes in six geo-political zones in Nigeria: important for the development of a National Food Composition Database and Dietary Assessment.

A cross-sectional study was undertaken to collect and assess commonly consumed foods/recipes from the six geopolitical zones in Nigeria for the production of food composition database (FCDB) for dietary assessment. Communities used were selected using a multi-stage sampling plan. Focus group discussions, interviews, recipe documentation, food preparations and literature reviews were employed. Qualitative methods were used to analyse and present data. SWOT (strengths, weaknesses, opportunities, and threats) analysis was used to evaluate the project. A total of 322 recipes were collected out of which 110 were soups. Food consumption patterns across the geographical zones were found to be changing. Variations in recipes and methods of preparation of similar foods were observed. Factors to be considered in the development of a country-specific FCDB were identified. There were challenges with the use of values reported in literature for Nigerian foods. The study justifies the need for a country-specific FCDB that will include traditional recipes.

Vitamin A deficiency is prevalent in children less than 5 y of age in Nigeria.

Vitamin A deficiency (VAD) is a serious and widespread public health problem in developing countries. We conducted a nationwide food consumption and nutrition survey in Nigeria to help fomulate strategies to address VAD, among other deficiencies. One objectives was to assess the vitamin A status of children <5 y old. A total of 6480 households with a mother and child <5 y old were randomly sampled. Blood samples were collected by venipuncture and processed to obtain serum for measurement of retinol concentration by HPLC. Nationwide, 29.5% of children <5 y old were vitamin A deficient (serum retinol <0.70 micromol/L). The proportions of children with VAD differed among the agroecological zones; incidences were 31.3% in the dry savanna, 24.0% in the moist savanna, and 29.9% in the humid forest (P < 0.001). More children (P < 0.05) with severe deficiency (serum retinol < 0.35 micromol/L) lived in the humid forest (7.1%) than in the dry (3.1%) or moist savanna (2.4%). The distribution of VA in children <5 y old was 25.6% in the rural sector, 32.6% in the medium, and 25.9% in the urban sector (P < 0.05). In conclusion, VAD is a severe public health problem in Nigeria. Although the proportion of children with low serum vitamin A levels varies agroecologically and across sectors, it is an important public health problem in all zones and sectors.