Designing a Contextualized Food-Based Strategy to Improve the Dietary Diversity of Children in Rural Farming Households in Central Uganda.

BACKGROUND: Food-based strategies have a high potential of improving the diet quality and reducing the prevalence of nutrient deficiencies in agriculture-dependent communities. Their design is however complex with trade-offs that are rarely systematically presented to allow replication and efficient contextualization. OBJECTIVE: The systematic design of a food-based strategy to improve the dietary diversity of children in rural farming communities in Uganda. METHODS: The intervention mapping protocol was used to provide a systematic approach to developing theory-based and evidence-based intervention methods and strategy. RESULTS: The priority behavioral and environmental determinants identified were related to food production, consumption, and efficacy while the personal determinants focused on knowledge, skills, self-efficacy, attitude, and outcome expectations. The aim of the resulting strategy was set to improve the availability, accessibility, and consumption of diverse foods, with a particular focus on production diversity, production practices, market access, and market diversity. Behaviour change methods were selected to enhance ability and self-efficacy, strategic goal setting, and provision of feedback. The strategy focused on household groups for learning, demonstration, practice, and social support. The validation showed that the determinants and actors incorporated in the strategy were important and relevant for improving the productivity, food availability, dietary diversity, livelihoods, and health of rural farming households and communities. CONCLUSION: Application of the protocol yielded a contextualized food-based strategy that can be adjusted for use in other smallholder contexts in developing countries by piloting implementation plans based on the strategy; reassessing the key determinants and implementing the revised strategy; or replicating the whole design process.

Plain language titleDesigning a Food-Based Strategy to Improve the Dietary Diversity of Children in Farming Households in Central UgandaPlain language summaryFood-based strategies have a high potential of improving the diet quality of communities that depend on agriculture for their food and livelihoods. However, the design of food-based strategies is complex and rarely systematically presented to allow replication and efficient contextualization. The intervention mapping protocol was used to systematically design a food-based strategy to improve the dietary diversity of children in rural farming communities in Uganda. Through this process, the main factors influencing dietary diversity were identified. The factors were related to food production and consumption, knowledge, skills, self-assuredness, attitude, and the expected outcomes. The developed strategy was designed to improve the availability, accessibility, and consumption of diverse foods. The strategy mainly focused on the diversity of foods produced by households, the production practices used, household access to markets, and the diversity of foods available in these markets. Household groups were central to the selected behavior change methods as they would provide an environment for learning, demonstration, practice, and provide social support. The strategy and its development process can be used as per the implementation plan or further adjusted for use in other smallholder settings in developing countries.

Pro-vitamin A carotenoid content of 48 plantain (Musa AAB genome) cultivars sourced from eastern Democratic Republic of Congo.

BACKGROUND: Vitamin A deficiency (VAD) is widespread in sub-Saharan Africa (SSA). Unlike in developed countries, where the main source of vitamin A comes from meat, the diet of poor populations in SSA is largely plant based. It is thus important to identify local / popular plants with higher vitamin A content for combating VAD. Banana (including plantains) is an important staple food crop in this region. The identification and promotion of vitamin A-rich banana cultivars could contribute significantly to the alleviation of VAD in areas heavily dependent on the crop. We assessed pro-vitamin A carotenoid (pVACs) content in the fruit pulp of 48 local plantains from eastern Democratic Republic of Congo, to identify cultivars that could help reduce VAD, especially among young children and women of reproductive age. RESULTS: Mean pVACs content varied from 175-1756 µg/100 gfw in ripe fruits. Significant increases (P < 0.001) in total pVACs content occurred after ripening in all cultivars except 'UCG II'. Retinol activity equivalents (RAE) in ripe fruits ranged from 12-113 µg/100 gfw. Fifteen plantain cultivars, including 'Adili II', 'Nzirabahima', 'Mayayi', 'Buembe', and 'Sanza Tatu' (associated with RAE values of 44 µg/100 gfw and above) can be considered as good sources of pVACs. Modest consumption (250 or 500 gfw) of the fruit pulp of the five best plantain cultivars at ripening stage 5 meets between 39-71% and 44-81% of vitamin A dietary reference intake (DRI) respectively, for children below 5 years old and women of reproductive age. CONCLUSION: The 15 best plantain cultivars (especially the top 5) could potentially be introduced / promoted as alternative sources of pro-vitamin A in banana-dependent communities, and help to reduce cases of VAD substantially. © 2019 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Content of Iron and Vitamin A in Common Foods Given to Children 12⁻59 Months Old from North Western Tanzania and Central Uganda.

Improving infant and young child feeding is an effective intervention to improve child growth. A cross-sectional study followed by observation of selected households was used to establish the most popular foods given to children 12⁻59 months old in Bukoba and Kiboga districts of Tanzania and Uganda, respectively. Six meals were identified: maize-based porridge, steamed-mashed banana served with beans, banana cooked with beans, banana cooked with groundnut sauce, stiff porridge (Ugali) served with beans and sardines, and cassava cooked with beans. Raw ingredients were transported to Universität für Bodenkultur, Austria, within 48 h and meals prepared following community validated procedures within 24 h by project team members that involved graduate students from East Africa and Europe. High-performance liquid chromatography (HPLC) analysis and microwave digestion followed by flame atomic absorption spectroscopy were used in establishing provitamin A carotenoids and iron content, respectively. Findings indicated no trace of vitamin A or iron in the maize-based porridge, whereas 2.28 mg/100 g ep (edible portion) and 1.18 mg/100 g ep of iron were recorded in stiff-porridge served with beans and sardines and banana cooked with beans, respectively. Banana-based foods had 23 to 43 vitamin A RAE (retinal activity equivalent) µg/100 g ep. With estimated average requirements of iron and vitamin A for children 1⁻3 years being 5 mg/day and 275 RAE µg/day, respectively, these foods are poor sources of these nutrients in their current form. Thus, there is a need to explore opportunities for modifying preparation methods and incorporating nutritious and diverse ingredients into the foods prepared for infants and young children in Eastern African countries.

Formulation of a drinkable peanut-based therapeutic food for malnourished children using plant sources.

High ingredient costs continue to hamper local production of therapeutic foods (TFs). Development of formulations without milk, the most expensive ingredient, is one way of reducing cost. This study formulated a ready-to-drink peanut-based TF that matched the nutrient composition of F100 using plant sources. Three least cost formulations namely, A, B and C were designed using computer formulation software with peanuts, beans, sesame, cowpeas and grain amaranth as ingredients. A 100 g portion of the TF provided 101-111 kcal, 5 g protein and 5.3-6.5 g fat. Consumer acceptability hedonic tests showed that the products were liked (extremely and moderately) by 62-65% of mothers. These results suggest that nutrient dense TFs formulated from only plant sources have the potential to be used in the rehabilitation phase of the management of malnourished children after clinical testing.