Utilising emerging perspectives at the global and regional level to frame multisectoral nutrition governance landscape in Kenya.

OBJECTIVE: Multisectoral nutrition governance (MNG) is a vital enabling determinant of improved nutrition outcomes. Despite this, it remains to be a complex phenomenon that lacks adequate understanding, especially in developing countries like Kenya. This narrative review aims to discuss the evolution of MNG, the current state of MNG, barriers and challenges, and based on these identify entry points for improvement within the complex governance structure in Kenya. DESIGN: The Peer Review of Electronic Search Strategies (PRESS) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to ensure rigorous and transparent identification of literature and interpretation. SETTING: Kenya and developing countries with similar contexts. PARTICIPANTS: The review included forty-five documents (peer-reviewed articles and grey literature) that reported on MNG in developing countries. RESULTS: We acknowledge that MNG is a complex and evolving determinant of better nutrition outcomes. The paper highlights challenges Kenya and other developing countries face such as inadequate leadership, inadequate coordination, insufficient capacity, inadequate monitoring and evaluation systems, and limited financial resources, among others. For Kenya in particular, there is inadequate understanding of what MNG is and how it can be effectively operationalised and tracked. CONCLUSIONS: To enhance understanding of MNG in Kenya, a country-specific assessment of MNG processes and impact outcomes using standard tools and defined metrics is vital. Such assessment will generate evidence of progress, successes, and challenges that will compel the government and stakeholders to invest more in multisectoral nutrition approaches to achieve its nutrition goals.

Hemoglobin and ferritin concentrations are positively associated with blood pressure and hypertension risk in older adults: a retrospective cross-sectional study, Sharpeville, South Africa.

BACKGROUND AND OBJECTIVES: We aimed to determine the association between Hemoglobin (Hb) and ferritin with blood pressure (BP) and risk of hypertension (HTN) among elderly South African adults in four time points over a period of 10 years. METHODS AND STUDY DESIGN: We used the data source from the Sharpeville Project conducted among the elderly in Sharpeville, South Africa (SA). A total of 275 subjects from the 2004 data source were included. Among these, data were available for 251, 114, and 81 subjects in 2007, 2012, and 2014 respectively. Confounding factors included age, BMI, sodium intake, high-sensitivity C-reactive protein (hs-CRP), and serum total cholesterol. Linear and logistic regressions were used to investigate the Hb and ferritin associations with BP and HTN risk. RESULTS: Mean age in 2004, 2007, 2012, and 2014 was 72.8±8.66, 75.8±7.28, 80.2±9.54, and 83.2±8.98 respectively. In the unadjusted model, systolic BP (SBP) and diastolic BP (DBP), after 132.2 and 83.6 mmHg, increased by 0.57 and 0.72 mmHg respectively for each increment increase in Hb. In the adjusted model, slope coefficients remained statistically significant. Adjusted OR (95% CI) for the highest quartile of Hb (Q4) compared to the first quartile (Q1) in 2004 (p<0.001) and 2007 (p=0.017) were 2.81(2.12-4.83) and 2.58 (1.18-5.65) respectively. Those in Q4 of ferritin had OR (95% CI) of 1.85(1.32-3.73) in 2004 (p<0.001) and 2.20 (1.24-4.04) in 2007 (p<0.001) compared to Q1. CONCLUSIONS: Consistencies between the results from both variables suggest that some part of these positive associations could be iron dependent. Caution should be taken about unmonitored iron supplements consumption among older adults particularly those with elevated BP or on antihypertensive medications.

The association between diet quality and subclinical inflammation among children aged 6-18 years in the Eastern Cape, South Africa.

OBJECTIVE: The study aimed to investigate, for the first time, the association between diet quality (food variety and dietary diversity), intakes of anti-inflammatory nutrients and food groups, and subclinical inflammation as assessed by categories of high-sensitivity C-reactive protein (hs-CRP). DESIGN: Cross-sectional study. SETTING: Resource-poor, rural children in the Eastern Cape, South Africa. SUBJECTS: A sample size formula determined a representative sample of 235. Five schools were purposively selected and cluster sampling used to select 240 participants. Measurements included 24 h recall and dietary diversity questionnaires, anthropometric and biochemical measurements. RESULTS: The sample consisted of 50·4 % (n 118) girls and 49·6 % (n 116) boys. No obesity was found, but overweight was prevalent in 4·2 % of the children. The hs-CRP concentration (median (25th, 75th percentile)) of the low, medium and high risk inflammatory categories was 0·6 (0·4, 0·7), 1·6 (1·2, 2·2) and 4·2 (3·4, 6·4) mg/l, respectively. Body composition parameters did not differ between hs-CRP groups. Most of the anti-inflammatory nutrient intakes (dietary Fe, Zn, Mg, vitamin C, folate, linolenic acid, linoleic acid, MUFA and PUFA) differed significantly between the hs-CRP groups, with intakes increasing from low to high hs-CRP groups, with similar results for linolenic acid (P=0·022) intake. No significant relationships between hs-CRP and any of the food groups could be established, but significant relationships were established between hs-CRP levels and the high density of living arrangements and unhygienic ablution facilities. CONCLUSIONS: Although no link could be established between overnutrition and hs-CRP levels, an association was found between hs-CRP and dietary quality, as well as socio-economic status.

Consumers' environmental and ethical consciousness and the use of the related food products information: The role of perceived consumer effectiveness.

Consumers can be important active contributors to a sustainable society by selecting food choices that are both healthy and produced respecting environmental and socially ethical standards. The current study investigates five consumer behavioural factors - namely, perceived consumer effectiveness (PCE); environmental conscious behaviour; concerns for ethical food production; health conscious lifestyle; and healthy dietary patterns. The key interest of the study lies in exploring the moderating role of PCE - the extent to which the consumer believes that his/her own efforts can make a difference - in these interrelationships. The empirical analysis was conducted through an online survey of food consumers implemented in three markets - the US, the UK and Germany. Findings indicate that for individuals with higher levels of PCE, who are environmental conscious and ethically concerned, information on food labels relating to environmental and social issues represents value by itself. Interestingly, health and nutrition information on food labels was not perceived valuable by consumers with high PCE. The predictive effects of various socio-demographic variables on PCE, consumer environmental and health consciousness are discussed. Cross-cultural differences are also outlined. The results of this research may contribute to the development of environmental policies and communication strategies of the food industry to enhance perceived consumer effectiveness among consumers. Improved PCE, in turn, may catalyze consumers' environmental behaviour and ethical concerns in relation to consumption of food products with environmental and social information.

Is obesity associated with iron status in the elderly? A case study from Sharpeville, South Africa.

OBJECTIVE: To investigate the relationship between poor Fe status and overweight or obesity in elderly respondents in South Africa. DESIGN: Cross-sectional, observational baseline survey. SETTING: Sharpeville, South Africa. SUBJECTS: A sample size calculation determined a representative sample of 104 randomly selected elderly (≥60 years) respondents. Measurements included weight, height, biochemical and haematological parameters. Measured BMI was used to categorise the respondents into normal weight, overweight and obese groups. RESULTS: The majority of the women were overweight (28·4%) or obese (54·6%); 58% of the respondents had normal Fe status, 15% were classified as Fe depleted, 9% as Fe deficient and 13% as Fe-deficient anaemic. Ten per cent of the respondents had low Hb levels with no other low Fe status parameters, and were thus anaemic due to other causes. A significant correlation (r = 0·318, P < 0·001) existed between BMI and high-sensitivity C-reactive protein (hs-CRP). hs-CRP was negatively correlated to serum Fe levels (r = -0·319, P < 0·001). No significant relationships existed between BMI and Fe status parameters. CONCLUSIONS: A coexistence of obesity and poor Fe status were observed in these elderly respondents. The positive relationship between hs-CRP and BMI indicated chronic inflammation in the higher BMI groups. The negative relationship between hs-CRP and serum Fe indicated that lower serum Fe levels were related to the inflammation linked with higher BMI. A relationship between obesity-related chronic, low-grade inflammation and poor Fe status has been found in adults, but the significance of the current study is that this relationship was also confirmed for elderly persons.

Nutrition knowledge and dietary intake of adolescents in Cofimvaba, Eastern Cape, South Africa.

The aim of the study was to assess the nutrition knowledge, nutrient intakes, and association between nutrition knowledge and dietary intakes of 98 adolescents attending five schools in rural Cofimvaba, South Africa. Measures included a socioeconomic questionnaire, two 24-hour-recall questionnaires, and food-frequency and nutrition knowledge questionnaires. The overall score for the multiple-choice section on general nutrition and the South African Food-Based Dietary Guidelines was 72.9%; 75.4% for correct identification of food groups; and 41.3% for correct identification of food portions/serving sizes. Median nutrient intakes, measured by 24-hour recall, failed to meet average requirements, with the exception of protein, carbohydrates, chromium, riboflavin, pantothenate, and vitamin K among girls. A similar trend was observed for boys. Lower total carbohydrate and fat and higher protein intakes were associated with a higher quartile score for nutrition knowledge. The study provided a valuable understanding of the association between nutrition knowledge and dietary intakes of adolescents.

Socio-Economic Variables and Nutrient Adequacy of Women in the Vaal Region of South Africa.

The aim of this cross-sectional, observational baseline survey was to examine the association between nutrient intakes and selected socio-economic variables in 722 women, aged 19 to 90 years living in peri-urban settlements. Measurements included socio-demographic data and 24-hour recall dietary intake data. The results showed poor nutrient intakes with the Estimated Average Requirement (EAR) not met for the mean intakes of all nutrients except carbohydrates, phosphorus, and vitamin B12. The inadequate energy intakes were significantly higher among the women who had lower education (p = .015), lower income (p = .028), and were unemployed (p = .015). The epidemiological value of the study findings is in the contribution to the rationale of appropriate interventions such as income-generating projects as well as household agricultural projects to improve food and nutrient intakes.

Effect of drying and cooking on nutritional value and antioxidant capacity of morogo (Amaranthus hybridus) a traditional leafy vegetable grown in South Africa.

Morogo (vegetables in Tswana) is a green leafy vegetable from the Amaranthaceae family that can be harvested from wild growing or cultivated. The objective of this study was to determine the nutritional value, the total antioxidant capacity and selected bioactive compounds present in morogo leaves, and evaluate the effect of drying and cooking. Results showed that morogo contained a significant amount of protein (3.6 ± 0.1 g/100 g FW) and minerals which the level exceed 1% of fresh weight. The total antioxidant capacity (µmole TE/ 100 g FW) determined by DPPH and FRAP assays were 118.3 ± 15.3 and 128.4 ± 11.9 respectively. Total polyphenols (109.4 ± 7.5 mg GAE/100 g FW), vitamin C (36.6 ± 1.0 mg /100 g FW) and carotenoids represented by ß carotene (25.3 ± 1.3 mg /100 g FW) and xanthophylls (7.48 ± 0.31 mg /100 g FW) formed a significant part of bioactive compounds content of morogo leaves. Since the boiling can cause significant losses of compounds in the boiling water, it can be recommended to avoid cooking methods that can include a boiling step with discard of boiling water.

Hungry, Stressed, and Away From "Home": Predictors of Food Security and Perceived Stress Among International Students.

PURPOSE: Examine the predictors of food security and perceived stress among international students. DESIGN: Cross-sectional Design. SETTINGS: A public university in the Southwest United States. SUBJECTS: Sample size of Seventy-three participants (≥18 years). MEASURES: Self-report measures of food insecurity and perceived stress. The U.S. Department of Agriculture (USDA) Adult Food Security Survey Module (AFSSM) to assess food security status, and the Perceived Stress Scale (PSS-10) questionnaire to evaluate stress levels. ANALYSIS: Logistic regression was performed to identify predictors of food security and perceived stress. RESULTS: Duration of stay in the U.S. was a predictor of food security status, while gender was a predictor of perceived stress. International students in the U.S. for less than a year had a lower chance of being food secure [OR (95% CI) = 0.22 (0.05 - 0.74)]. Female international students had a lower chance of experiencing low perceived stress [OR (95% CI) = 0.07 (0.00 - 0.51)]. CONCLUSION: In supporting international students, targeted nutrition and stress management interventions should be emphasized, particularly for females and those who recently moved to the U.S.

Associations between Cardiometabolic Risk Factors and Increased Consumption of Diverse Legumes: A South African Food and Nutrition Security Programme Case Study.

The programme aimed to improve selected cardiometabolic risk (CMR) variables using a nutritional intervention among farmers who reported hypertensive disorders as hindrances during agricultural activities. The intervention had two case controls (n = 103) [experimental group-EG (n = 53) and control group-CG (n = 50)] which were tracked and whose blood pressure measurements, dietary intake, blood indices for cholesterol concentration and glucose levels from pre- and post-intervention surveys after the baseline survey (n = 112) were analysed. The interval for data collection was 12 weeks (±120 days) after five legume varieties were consumed between 3 and 5 times a day, and servings were not <125 g per at least three times per week. Sixty-five per cent of farmers were above 60 years old, with mean age ranges of 63.3 (SD ± 6.3) years for women and 67.2 (SD ± 6.7) for men. The post-intervention survey revealed that EG blood results indicated nutrient improvement with p <= 0.05 for blood glucose (p = 0.003) and cholesterol (p = 0.001) as opposed to the CG. A trend analysis revealed that cholesterol (p = 0.033) and systolic blood pressure (SBP); (p = 0.013) were statistically significant when comparing genders for all study phases. Interventions focusing on legumes can improve hypertension and cardiovascular disease and fast-track the achievement of SGDs 3 and 12 through community-based programmes.

The Role of Artificial Intelligence in Nutrition Research: A Scoping Review.

Artificial intelligence (AI) refers to computer systems doing tasks that usually need human intelligence. AI is constantly changing and is revolutionizing the healthcare field, including nutrition. This review's purpose is four-fold: (i) to investigate AI's role in nutrition research; (ii) to identify areas in nutrition using AI; (iii) to understand AI's future potential impact; (iv) to investigate possible concerns about AI's use in nutrition research. Eight databases were searched: PubMed, Web of Science, EBSCO, Agricola, Scopus, IEEE Explore, Google Scholar and Cochrane. A total of 1737 articles were retrieved, of which 22 were included in the review. Article screening phases included duplicates elimination, title-abstract selection, full-text review, and quality assessment. The key findings indicated AI's role in nutrition is at a developmental stage, focusing mainly on dietary assessment and less on malnutrition prediction, lifestyle interventions, and diet-related diseases comprehension. Clinical research is needed to determine AI's intervention efficacy. The ethics of AI use, a main concern, remains unresolved and needs to be considered for collateral damage prevention to certain populations. The studies' heterogeneity in this review limited the focus on specific nutritional areas. Future research should prioritize specialized reviews in nutrition and dieting for a deeper understanding of AI's potential in human nutrition.

Snack consumption frequency of children and adults in the Vaal region of Gauteng, South Africa.

Background: Energy-dense, nutrient-poor snacks are associated with an increased risk of non-communicable diseases (NCDs) and the double burden of malnutrition, especially among poor communities. Aim: To determine and compare the snacking preferences and consumption frequency of children and adults from a low SES community in South Africa. Setting: A preschool, primary school, and an elderly centre in Gauteng. Methods: A cross-sectional study with a convenience sample of 90 children (3-8 years) and 100 adults (≥ 18 years) to assess snack consumption frequency and preferences of children and adults by means of a snack survey. Mann-Whitney U test was used to determine the differences in preferences and snack consumption frequency of children and adults. Results: The most preferred and consumed snacks included fruits, potato chips, corn chips, sweets, and cookies. Children frequently ate more potato chips (p < 0.001), corn chips (p < 0.001), cheese curls (p < 0.001), and muffins (p = 0.024) than adults. In contrast, adults frequently consumed more peanuts or nuts (p = 0.024), savoury biscuits (p = 0.048) and biltong (p < 0.001) than children. Conclusion: Apart from fruits, the most preferred and frequently consumed snacks by the sample were highly processed snacks, which are low in fibre and high in added sugars, saturated fat, and sodium. Contributions: Findings from this study highlight current snack trends and can guide future nutrition education interventions on healthy snacking and in developing nutritious snacks for the South African community.

Nutrition and health challenges among low-income families of young children in the post COVID-19 era: a qualitative study.

BACKGROUND/OBJECTIVES: In the United States, one in every 5 children is obese with greater likelihood in low-income households. The coronavirus disease 2019 (COVID-19) pandemic may have accelerated disparities in child obesity risk factors, such as poor dietary intake and increased sedentary behaviors, among low-income families because of financial difficulties, social isolation and other struggles. This study reveals insights into nutrition and health challenges among low-income families of young children in West Texas to better understand needs and develop interventions. SUBJECTS/METHODS: In-depth individual interviews were performed via Zoom among 11 families of children under the age of 3. A semi-structured interview guide was developed to explore 3 areas: changes in (1) dietary intake and (2) sedentary behaviors and (3) families' preferences regarding a parent nutrition education program. Each interview was audio-recorded, transcribed, and coded using MaxQDA software. RESULTS: Eating together as a family become challenging because of irregular work schedules during the COVID-19 pandemic. Most parents stated that their children's dietary habits shifted with an increased consumption of processed foods. Many parents are unable to afford healthful foods and have utilized food and nutrition assistance programs to help feed their families. All families reported that their children's screen time substantially increased compared to the pre-pandemic times. Moreover, the majority of parents did not associate child screen time with an obesity risk, so this area could be of particular interest for future interventions. Meal preparation ideas, remote modality, and early timing were identified as key intervention strategies. CONCLUSIONS: Online nutrition interventions that emphasize the guidelines for child screen time and regular meal routines will be effective and promising tools to reach low-income parents for early childhood health promotion and obesity prevention.

Development of a Structural Equation Model to Examine the Relationships between Genetic Polymorphisms and Cardiovascular Risk Factors.

Genome-wide association studies (GWASs) have been used to discover genetic polymorphisms that affect cardiovascular diseases (CVDs). Structural equation modelling (SEM) has been identified as a robust multivariate analysis tool. However, there is a paucity of research that has conducted SEM in African populations. The purpose of this study was to create a model that may be used to examine the relationships between genetic polymorphisms and their respective cardiovascular risk (CVR) factors. The procedure involved three steps. Firstly, the creation of latent variables and the hypothesis model. Next, confirmatory factor analysis (CFA) to examine the relationships between the latent variables, SNPs, dyslipidemia and metabolic syndrome, with their respective indicators. Then finally, model fitting using JASP statistical software v.0.16.4.0. The indicators for the SNPs and dyslipidemia all indicated significant factor loadings, -0.96 to 0.91 (p = <0.001) and 0.92 to 0.96 (p ≤ 0.001), respectively. The indicators for metabolic syndrome also had significant coefficients of 0.20 (p = 0.673), 0.36 (p = 0.645) and 0.15 (p = 0.576), but they were not statistically significant. There were no significant relationships observed between the SNPs, dyslipidemia and metabolic syndrome. The SEM produced an acceptable model according to the fit indices.

Effects of a Theory-Based, Multicomponent eHealth Intervention for Obesity Prevention in Young Children from Low-Income Families: A Pilot Randomized Controlled Study.

The purpose of this study was to evaluate a theory-based, multicomponent eHealth intervention aimed at improving child health behaviors and parental psychosocial attributes and feeding practices. A pilot randomized controlled trial was conducted among 73 parents with children (1-3 years). Intervention group participants (IG, n = 37) received theory-based educational videos, cooking tutorials, and text messages with key information for a total of 8 weeks. Control group participants (CG, n = 36) received a booklet about general nutrition recommendations for children. A parent-administered questionnaire was used for data collection at baseline and post-intervention. Linear models were performed using R version 4.1.1. for data analysis. Children in the IG significantly increased their daily intake of fruit (ΔΔ = 0.89 servings, p = 0.00057) and vegetables (ΔΔ = 0.60 servings, p = 0.0037) and decreased use of screen time (ΔΔ = -33.87 min, p = 0.026), compared to the CG. Parents in the IG improved significantly more than the CG in self-efficacy (p = 0.0068) and comprehensive feeding practices (p = 0.0069). There were no significant differences between the study groups for changes in child outcomes, such as physical activity and sedentary behaviors, and parental nutrition knowledge and attitudes.

Association of Dietary Changes with Risk Factors of Type 2 Diabetes among Older Adults in Sharpeville, South Africa, from 2004 to 2014.

This study aimed to evaluate the associations of dietary changes with risk factors of type 2 diabetes among older populations in Sharpeville, South Africa. A 24 h recall assessment, dietary diversity, and anthropometrics were measured. Blood samples were collected to assess fasting glucose and insulin. Regression analysis was performed using SPSS version 20. The mean BMI of the total of 103 participants was 30.63 kg/m2 at baseline and 29.66 kg/m2 at follow-up. Significantly higher BMI levels were reported in women than men both at baseline (p = 0.003) and follow-up (p = 0.009). Waist circumference significantly decreased from 96.20 cm to 93.16 cm (p = 0.046). The mean levels of HOMA-B significantly increased from 88.99 to 111.19 (p = 0.021). BMI was positively associated with intakes of total energy (p = 0.22), polyunsaturated fatty acids (p = 0.050), and cholesterol (p = 0.006). Waist circumference was strongly associated with total energy (p = 0.048), polyunsaturated fatty acids (p = 0.037), trans fatty acids (p = 0.039), and cholesterol (p = 0.000). HOMA-IR and HOMA-B were associated with intakes of fat (HOMA-IR: p = 0.013; HOMA-B: p = 0.040) and monounsaturated fatty acids (HOMA-IR: p = 0.003; HOMA-B: p = 0.040).

Social Determinants of Rural Household Food Insecurity under the Taliban Regime.

Despite the severity of food insecurity in Afghanistan, little is known about the factors contributing to household food insecurity (HFI) under the Taliban regime. Therefore, this paper investigated the social determinants of severe HFI in rural areas of Afghanistan. We used the fifth-round survey of 6019 rural households from 25 provinces, collected between July and August 2022 by the Food and Agriculture Organization. We used binary logistic regression to examine the association between household characteristics and HFI. The majority of household heads were male (97.8%) with no education (62.8%). The findings showed that female-headed households had significantly higher odds of severe HFI. Household heads with any level of formal education had significantly reduced odds of severe HFI, while the odds of severe HFI was not different among those with religious/informal household-head education compared to those with no education. Likewise, engagement in any type of agricultural activity decreased the odds of severe HFI. Additionally, household income per member was negatively, while household size was positively associated with severe HFI. In summary, interventions to alleviate HFI among rural households should prioritize income-generating opportunities and skills targeting households with female heads, low levels of household-head education, larger size, no agricultural activities, and low income.

Effects of Nutritional and Social Factors on Favorable Fetal Growth Conditions Using Structural Equation Modeling.

Poor birth outcomes such as low birth weight, low birth length and short gestational age, are public health concern issues in South Africa (SA). This study utilized structural equation modeling (SEM) to explore how nutritional and social factors contribute to favorable fetal growth conditions (FFGC) in pregnant women living with and without human immunodeficiency virus (HIV), in the Free State Province of SA. Sociodemographic characteristics, stress, health and nutrition-related information, and birth outcomes data were collected and analyzed from a subsample of 305 women enrolled in a cohort study from 2018−2020. Descriptive statistics were analyzed in R version 4.1.2 and SEM was conducted in Lavaan version 0.6−5. Higher gestational body mass index (GBMI) and income levels were associated with higher FFGC (p < 0.05). Household incomes were positively associated with dietary micronutrient quality (p = 0.002), GBMI (p = 0.012) and food security (p = 0.001). Low incomes (p = 0.004) and food insecurity (p < 0.001) were associated with higher stress, while social support was positively associated with food security status (p = 0.008). These findings highlight the complex interconnections between the social and nutritional factors that are associated with fetal growth conditions. Multisectoral community-based programs may be a useful strategy to address these challenges.

Is food insecurity a problem among the elderly in Sharpeville, South Africa?

The objective of this study was to determine the prevalence of food and nutrition insecurity and assess the socio-demographic factors associated with food and nutrition insecurity among 146 free-living elderly persons attending a care centre in Sharpeville, South Africa. Measurement instruments included socio-demographic-, 24-hour-recall and dietary diversity questionnaires and the validated household food insecurity access scale/score (HFIAS). Data were analysed with IBM SPSS Software, version 25.0. The prevalence of food insecurity from HFIAS was 60% (n = 87), with a variety of balanced responses being employed. Significant relationships were observed between HFIAS and age (r = 0.301; p = 0.000) and with household income (r = -0.258; p = 0.007). An association was observed between HFIAS and marital status (p = 0.005). Regression analysis showed that age and being single were predictors of food and nutrition insecurity. This study indicated a problem of household food insecurity with poor dietary intakes among these elderly people, mostly due to poverty and being single. More research on associations between food security and socio-economic variables is needed to plan and implement appropriate strategies to address food and nutrition insecurity in South Africa.

Prevalence and Factors Associated with Food Insecurity among Older Adults in Sub-Saharan Africa: A Systematic Review.

Food insecurity has been undermining the health and well-being of a growing number of older adults in Sub-Saharan Africa. This review aimed to examine the prevalence of food insecurity and the related contributing factors of food insecurity among older adults in Sub-Saharan Africa. We used PubMed, Scopus, ScienceDirect, and Web of Science Core Collection as our search engines and included 22 articles for data extraction. Prevalence of severe and moderate food insecurity in households with older adults ranged from 6.0 to 87.3% and from 8.3 to 48.5%, respectively. Various socio-economic (e.g., low education level, being widowed, low income, lower wealth position of households, living in a rental house, living in rural areas, lack of social grants or pensions), demographic (e.g., female, Black racial group, larger family size), and health and nutrition status-related (e.g., self-reported poor health status, having a functional and mobility-related disability, psychological disorders) factors influence food insecurity in older adults in Sub-Saharan Africa. The findings of this review can help stakeholders to prioritize the issue of food insecurity, design and implement policies and programs to improve food security among older adults in Sub-Saharan Africa.