Dietary species richness as a measure of food biodiversity and nutritional quality of diets.

Biodiversity is key for human and environmental health. Available dietary and ecological indicators are not designed to assess the intricate relationship between food biodiversity and diet quality. We applied biodiversity indicators to dietary intake data from and assessed associations with diet quality of women and young children. Data from 24-hour diet recalls (55% in the wet season) of n = 6,226 participants (34% women) in rural areas from seven low- and middle-income countries were analyzed. Mean adequacies of vitamin A, vitamin C, folate, calcium, iron, and zinc and diet diversity score (DDS) were used to assess diet quality. Associations of biodiversity indicators with nutrient adequacy were quantified using multilevel models, receiver operating characteristic curves, and test sensitivity and specificity. A total of 234 different species were consumed, of which <30% were consumed in more than one country. Nine species were consumed in all countries and provided, on average, 61% of total energy intake and a significant contribution of micronutrients in the wet season. Compared with Simpson's index of diversity and functional diversity, species richness (SR) showed stronger associations and better diagnostic properties with micronutrient adequacy. For every additional species consumed, dietary nutrient adequacy increased by 0.03 (P < 0.001). Diets with higher nutrient adequacy were mostly obtained when both SR and DDS were maximal. Adding SR to the minimum cutoff for minimum diet diversity improved the ability to detect diets with higher micronutrient adequacy in women but not in children. Dietary SR is recommended as the most appropriate measure of food biodiversity in diets.

Traditional Individual and Environmental Determinants of Healthy Eating in Vihiga County, Western Kenya.

Traditional ethnic groups in Kenya are unlikely to eat a healthy and diversified diet due to many individual and environmental factors, which may result in poor health status. Therefore, the determinants of eating behavior need to be identified prior to any public health action. For this study, focus group discussions (15 in total) in a double-layer design were conducted, comprising adult men and women from 5 villages of Vihiga County. Questions explored knowledge; barriers and cues to action toward eating a healthy diet containing a variety of foods; including indigenous food species. We found that healthy eating concepts are known; however, several taboos that restrict food consumption reduce local diet quality in terms of diversity. Nutrition education is a cue to action. We identified several individual and environmental determinants of eating behavior in the studied communities. Public health action should focus on supporting healthy eating behaviors and refining some taboos' beliefs.

Born to Eat Wild: An Integrated Conservation Approach to Secure Wild Food Plants for Food Security and Nutrition.

Overlooked in national reports and in conservation programs, wild food plants (WFPs) have been a vital component of food and nutrition security for centuries. Recently, several countries have reported on the widespread and regular consumption of WFPs, particularly by rural and indigenous communities but also in urban contexts. They are reported as critical for livelihood resilience and for providing essential micronutrients to people enduring food shortages or other emergency situations. However, threats derived from changes in land use and climate, overexploitation and urbanization are reducing the availability of these biological resources in the wild and contributing to the loss of traditional knowledge associated with their use. Meanwhile, few policy measures are in place explicitly targeting their conservation and sustainable use. This can be partially attributed to a lack of scientific evidence and awareness among policymakers and relevant stakeholders of the untapped potential of WFPs, accompanied by market and non-market barriers limiting their use. This paper reviews recent efforts being undertaken in several countries to build evidence of the importance of WFPs, while providing examples of cross-sectoral cooperation and multi-stakeholder approaches that are contributing to advance their conservation and sustainable use. An integrated conservation approach is proposed contributing to secure their availability for future generations.

Barriers to Eating Traditional Foods Vary by Age Group in Ecuador With Biodiversity Loss as a Key Issue.

OBJECTIVE: To document the perceptions of indigenous peoples for the sustainable management of natural resources against malnutrition. DESIGN: Initially 4 and then 12 interviews were conducted with 4 different age groups. SETTING: Eight rural villages in Guasaganda, central Ecuador, were studied in 2011-2012. PARTICIPANTS: A total of 75 people (22 children, 18 adolescents, 20 adults, and 15 elders). MAIN OUTCOME MEASURES: Benefits, severity, susceptibility, barriers, cues to action, and self-efficacy of eating traditional foods. ANALYSIS: Qualitative content analysis was completed using NVivo software. Initial analysis was inductive, followed by a content analysis directed by the Health Belief Model. Coding was completed independently by 2 researchers and kappa statistics (κ ≥ 0.65) were used to evaluate agreement. RESULTS: Healthy perceptions toward traditional foods existed and differed by age. Local young people ate traditional foods for their health benefits and good taste; adults cultivated traditional foods that had an economic benefit. Traditional knowledge used for consumption and cultivation of traditional foods was present but needs to be disseminated. CONCLUSIONS AND IMPLICATIONS: Nutrition education in schools is needed that supports traditional knowledge in younger groups and prevents dietary changes toward unhealthy eating. Increased production of traditional food is needed to address current economic realities.

Educación nutricional durante la alimentación enteral en domicilio de un caso con Síndrome de Wolf Hirschhorn en Ecuador / Nutrition education during enteral feeding at home in a case of Wolf Hirschhorn in Ecuador

INTRODUCCIÓN: El Síndrome de Wolf Hirschhorn es un trastorno genético, que ocurre en 1 de cada 50000 nacidos vivos, producto de la deleción del brazo corto del cromosoma 4. Existe limitada información sobre el correcto manejo de alimentación enteral en pacientes domiciliados. OBJETIVOS: Evidenciar que el uso de educación nutricional para alimentación enteral diseñado específicamente para un paciente con Síndrome de Wolf Hirschhorn permite la mejora en su estado nutricional. MÉTODOS: Este artículo comprende la investigación realizada a una paciente adolescente género femenino, diagnosticada con el Síndrome de Wolf Hirschhorn con peso inicial de 25.8 kg, y talla de 134 cm. Historia clínica incluye trastorno de deglución, ausencia de reflejo de masticación, alimentación enteral vía gastrostomía, reflujo gastroesofágico, estreñimiento, ausencia de habilidades motrices, intelectuales y de lenguaje. Se realizó seguimiento de alimentación enteral por 8 semanas. RESULTADOS: Se encontró que la educación nutricional propicia mejora significativa del estado nutricional de pacientes con El Síndrome de Wolf Hirschhorn. Se logró aumento de peso corporal, pliegues bicipital y tricipital en 1 kg, 2 mm y 2.3 mm, respectivamente; y aumento de ingesta de micro y macronutrientes. DISCUSIÓN: Es imprescindible educar al personal encargado de alimentar a pacientes domiciliados con el Síndrome de Wolf Hirschhorn empleando una guía. CONCLUSIONES: La alimentación enteral en el paciente domiciliado fue exitosa usando la herramienta diseñada para el contexto específico

INTRODUCTION: Wolf Hirschhorn Syndrome is a genetic disorder, occurring in 1 in 50000 births, resulting from the deletion of the short arm of chromosome 4. There is limited information on the correct management of enteral feeding in home patients. OBJECTIVES: To evidence the contribution of using enteral nutrition education specifically designed for a patient with Wolf Hirschhorn Syndrome to the improvement of the nutritional status. METHODS: This research includes the follow up of a female adolescent, diagnosed with Wolf Hirschhorn Syndrome who had an initial body weight of 25.8 kg, and 134 cm of length. Medical history includes swallowing disorder, absence of chewing reflex, enteral feeding via gastrostomy, gastroesophageal reflux, constipation, absence of motor, intellectual and language skills. Enteral feeding was tracked for 8 weeks. RESULTS: We found that nutrition education promotes a significant improvement in the nutritional status of patients with Wolf Hirschhorn Syndrome. Body weight gain, bicipital and tricipital folds were increased by 1 kg, 2 mm and 2.3 mm, respectively; and also an increased intake of micro and macronutrients. DISCUSSION: It is essential to educate the staff in charge of feeding home patients with Wolf Hirschhorn Syndrome using a guide. CONCLUSIONS: Enteral feeding at home was successful using the designed tool for the specific context

A conceptual framework for healthy eating behavior in ecuadorian adolescents: a qualitative study.

OBJECTIVE: The objective of this study was to identify factors influencing eating behavior of Ecuadorian adolescents - from the perspective of parents, school staff and adolescents - to develop a conceptual framework for adolescents' eating behavior. STUDY DESIGN: Twenty focus groups (N=144 participants) were conducted separately with adolescents aged 11-15 y (n (focus groups)=12, N (participants)=80), parents (n=4, N=32) and school staff (n=4, N=32) in rural and urban Ecuador. A semi-structured questioning route was developed based on the 'Attitude, Social influences and Self-efficacy' model and the socio-ecological model to assess the relevance of behavioral and environmental factors in low- and middle-income countries. Two researchers independently analyzed verbatim transcripts for emerging themes, using deductive thematic content analysis. Data were analyzed using NVivo 8. RESULTS: All groups recognized the importance of eating healthily and key individual factors in Ecuadorian adolescents' food choices were: financial autonomy, food safety perceptions, lack of self-control, habit strength, taste preferences and perceived peer norms. Environmental factors included the poor nutritional quality of food and its easy access at school. In their home and family environment, time and convenience completed the picture as barriers to eating healthily. Participants acknowledged the impact of the changing socio-cultural environment on adolescents' eating patterns. Availability of healthy food at home and financial constraints differed between settings and socio-economic groups. CONCLUSION: Our findings endorse the importance of investigating behavioral and environmental factors that influence and mediate healthy dietary behavior prior to intervention development. Several culture-specific factors emerged that were incorporated into a conceptual framework for developing health promotion interventions in Ecuador.

A systematic review on the contributions of edible plant and animal biodiversity to human diets.

The sustainable use of natural and agricultural biodiversity in the diet can be instrumental to preserve existing food biodiversity, address malnutrition, and mitigate adverse effects of dietary changes worldwide. This systematic review of literature summarizes the current evidence on the contribution of plant and animal biodiversity to human diets in terms of energy intake, micronutrient intake, and dietary diversification. Peer-reviewed studies were searched in ten databases using pre-defined search terms. Only original studies assessing food biodiversity and dietary intake were included, resulting in a total of 34 studies. 7, 14, and 17 studies reported information in relation to energy intake, micronutrient intake, and dietary diversification, respectively. In general, locally available foods were found to be important sources of energy, micronutrients, and dietary diversification in the diet of particularly rural and forest communities of highly biodiverse ecosystems. The current evidence shows local food biodiversity as important contributor of nutritious diets. Findings are, however, limited to populations living in highly biodiverse areas. Research on the contribution of biodiversity in diets of industrialized and urban settings needs more attention. Instruments are needed that would more appropriately measure the dietary contribution of local biodiversity.