Agriculture for Food and Nutrition Security: A Must For Achieving the Millennium Development Goals in Africa

The Millennium Development Goals (MDGs) underscore an overriding importance of human development for sustained economic, social, political and other development, and nutrition is the beginning of human development. Nutrition has, however, not been viewed as a development imperative in many African countries. Agricultural and health policies, projects and programmes and the conduct of agricultural and health research in most African countries do not consider nutrition to any significant degree. The paper argues that food production, poverty, malnutrition and health are very intricately linked and the result of that linkage is probably the most important determinant of development and, thus, the realization of the MDGs in Africa. It also argues that it is a misconception that food security implies or is synonymous with food and nutrition security. The paper proposes that food policies, projects, programmes and research should focus on food and nutrition security and not just food security. In that regard, the paper proposes that the following interlinked processes must be taken into consideration in agricultural policies, projects, programmes and research: (1) Effective marriage of indigenous and “scientific” knowledge in food production, processing, preservation, preparation and consumption. (2) Promotion of agrobiodiversity, including the domestication of known nutritionally-rich semi-wild plants. (3) Development of sustainable farming systems, including effective crop-livestock integration systems. (4) Development of food production-marketing-consumption-nutrition linkage processes at community levels. National and local level nutrition policy research and advocacyAgricultural and Food Policy, Community/Rural/Urban Development, Environmental Economics and Policy, Farm Management, Food Consumption/Nutrition/Food Safety, Food Security and Poverty, International Relations/Trade, Marketing, Production Economics, Research and Development/Tech Change/Emerging Technologies,

Exploratory and multidisciplinary survey of the cowpea network in the Tolon-Kumbungu district of Ghana: A food sovereignty perspective

An exploratory survey of selected deprived communities in the Tolon-Kumbungu district of northern region of Ghana was conducted in August 2007 by a multi-disciplinary team of social scientist, food technologist, plant breeder and food nutritionist. The survey sought to identify with farmers their critical agronomic needs and production constraints in order to develop appropriate breeding strategies, as well as cowpea varietal preference for improved processing technology development. A rural participatory and conventional survey approaches were used. Close to half of the interviewed farmers cultivate both improved and local varieties. It was realized that 33 and 22% cultivated only local and improved varieties respectively. Generally, farmers indicated preference for improved varieties due to market value but rather preferred local varieties for household consumption and food sovereignty purposes. The top three most preferred varietal traits mentioned by farmers for breeding considerations included yield, tolerance to diseases and pests and seed colour. Processors preferred white seed coat varieties due to their good whipping ability and short cooking period. Farmers stressed the role of local varieties in food sovereignty with the early maturing ones being the most significant in household food provisio

Efficacy of iron fortified cowpea flour in improving iron status of schoolchildren in malaria endemic rural Ghana

Children in sub-Saharan Africa are more likely to have survived the critical first 1000 days of life carrying along unresolved micronutrient deficiencies into the school-age. Iron-deficiency is the most prevalent micronutrient problem affecting school-age children in sub-Saharan Africa and yet the most difficult to resolve. It is necessary to ensure an adequate iron intake through the diet of school-age children and school-based feeding intervention may be a way to improve iron intake of schoolchildren. Such a feeding intervention would be more sustainable if it relies on locally produced food(s) with the potential to support food sovereignty. In this context, this thesis investigated whether foods based on cowpeas, an indigenous legume crop originating from Africa, can be used in a school feeding setting to improve iron status of school-age children in Ghana. The investigations in this thesis comprised cross-sectional dietary and iron status assessment of schoolchildren (n=383), cowpea acceptability among schoolchildren (n=120 mother-child pairs), chemical analysis of cowpea landraces (n=14), an in vivo iron bioavailability among young women (n=16) and a randomized cowpea intervention trial (n=241) conducted mainly in Tolon-Kumbungu district of Ghana. The results indicated that iron-deficiency and iron-deficiency anaemia affect 8 and 7 out of every 10 schoolchildren respectively. It also showed that the probability of adequate dietary iron intake is 0.32 but much larger (~0.90) if schoolchildren benefitted from a school feeding programme. Mothers/caregivers intended to give cowpeas to their schoolchildren 2–3 times per week. The positive attitudes of mothers towards cowpea predicted their intention to give them to their schoolchildren but they were worried about the cost, long cooking time and the discomfort their children may suffer after consuming cowpeas. The chemical analysis showed that cowpeas contain appreciable amounts of iron (4.9–8.2 mg/ 100 gd.w) and zinc (2.7–4.1 mg/100 gd.w) but also high amounts of inhibitory phytate (477–1110 mg/100 gd.w) and polyphenol (327–1055 mg/100 gd.w). Polyphenol concentration in particular was higher (PP PPPPP Overall, this thesis has shown that in a malarious region with high iron-deficiency like (northern) Ghana, iron status of schoolchildren can be improved through the consumption of cowpeas within a school feeding programme. The improvement in iron status is however unlikely to result from the usual/conventional consumption of cowpeas but through fortification of whole cowpea flour with a highly bioavailable iron compound. This thesis has also shown that the most suitable iron compound for such whole cowpea flour fortification is NaFeEDTA irrespective of whether the cowpea has high or low concentration of polyphenols.</p

Ramadan fasting alters food patterns, dietary diversity and body weight among Ghanaian adolescents.

BACKGROUND: Ramadan is a monthlong fast for healthy adolescents and adult Muslims. The quality of foods eaten and eating patterns in Ramadan may be different from other months of the year. Food intake of adolescents is a concern as energy and nutrient requirements are higher and needed to support the growth spurt of this stage. The objective of the present study was to describe the food patterns, dietary diversity and body weight changes among adolescents during Ramadan. METHODS: A prospective cohort study design with four measurement points (baseline, midline, endline and post endline) was conducted among 366 adolescents in Junior High Schools. Food pattern was assessed with a food frequency questionnaire, a 24-h dietary recall was used to assess dietary diversity and body weight was measured using an electronic scale. A repeated measures ANOVA was used to compare changes in dietary diversity scores (DDS) and weight of pupils. RESULTS: Half of the pupils (50.3%) were female and average age was 15.9 ± 1.8 years. Pupils fasted for an average of 28.3 ± 4.0 days and 14.3 ± 0.5 h a day (dawn to dusk) during Ramadan. The number and types of dishes taken at meal times differed substantially between Ramadan periods and outside Ramadan. Consumption of vitamin A-rich fruits, other fruits, and milk and milk products increased markedly during Ramadan. However, fasting came with a reduction in consumption of foods from roots and tubers, legumes and nuts, and dark green leafy vegetables while other food groups remained unchanged. Mean DDS increased significantly during Ramadan (F (2.933, 1070.573) = 7.152, p < 0.001) while mean daily meal frequency decreased (F (2.936, 1071.623) = 51.653, p < 0.001). There was significant body weight loss (-1.5 kg (95% CI: -1.1 kg to -1.6 kg)) among adolescents (F (2.656, 958.95) = 304.90, p < 0.001). Weight loss was short-lived; regained one month after Ramadan. CONCLUSION: In this prospective cohort study among schooling Ghanaian adolescents who fast during Ramadan, fasting was characterised by marked changes in usual food patterns, increased dietary diversity and significant body weight loss

Dietary patterns and associated factors of schooling Ghanaian adolescents

Background: Assessment of single nutrients or foods does not normally reflect the diet of population groups. Dietary pattern analyses are useful in understanding the overall diet and its relationship with disease conditions. The objective of the present study was to determine the dietary patterns and associated factors among schooling adolescents in Northern Ghana. Methods: A cross-sectional study involving 366 pupils in 10 junior high schools in the Tamale metropolis was conducted. A Food Frequency Questionnaire (FFQ) which consisted of 60 commonly consumed foods was used to assess pupils\u2019 7-day intake. Foods grouped (14) from FFQ data based on shared nutritional value were used to identify dietary patterns using principal component analysis (PCA). Bivariate and multivariate logistic regression analyses were used to determine the association between identified patterns and sociodemographic, anthropometric status, and household characteristics of pupils. Results: Half of the pupils were female (50.3%) and average age was 15.6 \ub1 2.0 years. PCA identified two dietary patterns which in total explained 49.7% of the variability of the diet of pupils. The patterns were sweet tooth pattern (STP) with high factor loadings for sugar sweetened snacks, energy and soft drinks, sweets, tea and coffee, and milk and milk products, and a traditional pattern (TP) which showed high factor loadings for cereals and grains, local beverages, nuts, seeds and legumes, vegetables, and fish and seafood. Logistic regression showed that pupils who lived with their parents [AOR = 1.95; 95% CI (1.1\u20133.4); p = 0.019], those who went to school with pocket money [AOR = 4.73; 95% CI (1.5\u201315.0); p = 0.008], and those who lived in the wealthiest homes [AOR = 3.4; 95% CI (1.6\u20137.5); p = 0.002)] had higher odds of following the STP. The TP was associated with high dietary diversity (p = 0.035) and household wealth [AOR = 3.518; 95% CI (1.763\u20137.017); p &lt; 0.001)]. None of the patterns was associated with anthropometric status of pupils. Conclusion: Adolescents in the present study followed a sweet tooth or a traditional diet pattern which associated more with household- and individual-level factors but not anthropometric status

Cowpeas in Northern Ghana and the Factors that Predict Caregivers’ Intention to Give Them to Schoolchildren

Background Cowpeas are important staple legumes among the rural poor in northern Ghana. Our objectives were to assess the iron and zinc content of cowpea landraces and identify factors that predict the intention of mothers/caregivers to give cowpeas to their schoolchildren. Methods and Findings We performed biochemical analysis on 14 landraces of cowpeas and assessed the opinion of 120 caregiver-child pairs on constructs based on the combined model of the Theory of Planned Behaviour and Health Belief Model. We used correlations and multiple regressions to measure simple associations between constructs and identify predictive constructs. Cowpea landraces contained iron and zinc in the range of 4.9–8.2 mg/100 g d.w and 2.7–4.1 mg/100 g d.w respectively. The landraces also contained high amounts of phytate (477–1110 mg/100 g d.w) and polyphenol (327–1055 mg/100 g d.w). Intention of mothers was strongly associated (rs = 0.72,

Trends and Factors Associated with the Nutritional Status of Adolescent Girls in Ghana:A Secondary Analysis of the 2003-2014 Ghana Demographic and Health Survey (GDHS) Data

Objective: We examined the trends over time and the factors associated with malnutrition among adolescent girls in Ghana. Design: Cross-sectional analysis from 3 nationwide Ghana Demographic and Health Surveys conducted in 2003 (n 983), 2008 (n 955) and 2014 (n 857). We used Cox proportional hazard models with sample weighting to model the prevalence ratio (PR) of malnutrition. Setting: Countrywide, covering rural and urban areas in Ghana. Participants: Non-pregnant adolescent girls aged 15–19 years. Results: Compared with 2003, thinness declined marginally (PR 0·88 (95 % CI 0·45, 1·73)) in 2008 and in 2014 (PR 0·71 (95 % CI 0·38, 1·56)). Stunting declined marginally by 19 % in 2008 (PR 0·81 (95 % CI 0·59, 1·12)), flattening out in 2014 (PR 0·81 (95 % CI 0·57, 1·17)). We found an increasing trend of overweight/obesity with the PR peaking in 2014 (PR 1·39 (95 % CI 1·02, 1·88)) compared to 2003. The anaemia prevalence remained severe without a clear trend. A low level of education of the adolescent girl was positively associated with stunting. Increasing age was positively associated with stunting but inversely associated with thinness and anaemia. Girls who ever bore a child were more likely to be anaemic compared to those who never did. A lower level of household wealth and a unit increase in household size was negatively associated with overweight/obesity. Urban dwelling girls were less likely to be stunted. Conclusions: The stagnant burden of under-nutrition and rising over-nutrition emphasise the need for double-duty actions to tackle malnutrition in all its forms in Ghanaian adolescent girls

Malnutrition, Hypertension Risk, and Correlates:An Analysis of the 2014 Ghana Demographic and Health Survey Data for 15–19 Years Adolescent Boys and Girls

The sex differences in malnutrition and hypertension during adolescence is largely inconclusive. There is also a paucity of data on the sex-specific correlates of malnutrition and hypertension for adolescents. Hence, this study aimed to assess the association between malnutrition, pre-hypertension/hypertension (PHH) and sex among adolescents. The study also aimed to determine and contrast the factors associated with these risks in Ghana. We analysed data of non-pregnant adolescent girls (n = 857) and adolescent boys (n = 870) aged 15–19 years from the 2014 Ghana Demographic and Health Survey (DHS). We modelled the prevalence risk ratio (PRR) of malnutrition and PHH using Cox proportional hazard models. Compared to adolescent girls, boys were more than twice likely to be stunted (PRR = 2.58, 95% C.I (1.77, 3.76)) and underweight (PRR = 2.67, 95% C.I (1.41, 5.09)) but less likely to be overweight/obese (PRR = 0.85, 95% C.I (0.08, 0.29)). Boys were also about twice likely to have PHH (PRR = 1.96, 95% C.I (1.47, 2.59)) compared to their female peers. Girls were more at risk of the detrimental effects of poor education on stunting and PHH. Empowerment index while protective of stunting for girls (PRR = 0.82, 95% C.I (0.67, 0.99)) also increased their risk of overweight/obesity (PRR = 1.31, 95% C.I (1.02, 1.68)). A higher household wealth index (HWI) increased the risk of overweight/obesity for adolescent girls but was protective of stunting and PHH for adolescent boys. Improvement in household water, hygiene, and sanitation (WASH) reduced the risk of stunting by 15% for adolescent boys. Overall, our findings suggest a double-burden of malnutrition with an up-coming non-communicable disease burden for adolescents in Ghana. Our indings may also be highlighting the need to target adolescent boys alongside girls in nutrition and health intervention programmes.</p

Free Senior High School Lunch Contributes to Dietary Quality of Nonresidential Students in Ghana.

BACKGROUND: School feeding offers an excellent opportunity for targeted intervention to students not only as means for improving educational outcomes but also enhancing nutritional outcomes. The Government of Ghana introduced the free lunch feeding policy for nonresidential students in senior high schools (SHS) in 2018. OBJECTIVE: We assessed unintended benefits of the free lunch program to dietary improvement. METHODS: This was an analytical cross-sectional study among 403 (202 beneficiary and 201 non-beneficiary) students in SHS. The Food and Agriculture Organization's standard procedure for measuring dietary diversity score (DDS) was followed. A 3-day dietary recall was used to assess school day DDS, while a 24-hour recall was used to assess weekend DDS of students. Differences in DDS and food group consumption were determined using student t test and χ2 test, respectively. RESULTS: Nearly all (98.5%) beneficiary students consumed the free school lunch and 7 (70%) in 10 of them consumed it on all school days. While the students did not differ in their weekend meal DDS (6.3 ± 1.4 vs 6.5 ± 1.4, P = .39), beneficiaries of the school lunch had higher lunch DDS (7.5 ± 0.5 vs 6.5 ± 1.4, P < .001) and whole day DDS (11.5 ± 1 vs 9.3 ± 2.0, P < .001) compared to non-beneficiary students on school days. Even though the school lunch increased food group intake, vitamin-A rich vegetables and tubers, fruits, flesh and organ meats, and dairy products were hardly provided as components of school lunch. CONCLUSION: Provision of free school lunch meal to nonresidential students in SHSs in Ghana could contribute to improved diet quality