• Applying the Food Multimix concept for sustainable and nutritious diets

      Zotor, Francis B.; Ellahi, Basma; Amuna, Paul; University of Health and Allied Sciences; University of Chester (Cambridge University Press, 2015-08-11)
      Background: Despite a rich and diverse ecosystem and biodiversity, worldwide, more than 2 billion people suffer from micronutrient malnutrition or hidden hunger. Of major concern are a degradation of our ecosystems and agricultural systems which are thought to be unsustainable thereby posing a challenge for the future food and nutrition security. Despite these challenges, nutrition security and ensuring well balanced diets depend on sound knowledge and appropriate food choices in a complex world of plenty and want. We have previously reported on how the food multimix (FMM) concept, a food-based and dietary diversification approach can be applied to meeting energy and micronutrient needs of vulnerable groups through an empirical process. Our objective in this article is to examine how the concept can be applied to improve nutrition in a sustainable way in otherwise poor and hard-to-reach communities. We have reviewed over 100 FMM food recipes formulated from combinations of commonly consumed traditional candidate food ingredients; on average five per recipe, and packaged as per 100 g powders from different countries including Ghana, Kenya, Botswana, Zimbabawe and Southern Africa, India, Mexico, Malaysia and United Kingdom; and for different age groups and conditions such as older infants and young children, pregnant women, HIV patients, diabetes and for nutrition rehabilitation. Candidate foods were examined for their nutrient strengths and nutrient content and nutrient density of recipes per 100 g were compared to reference nutrient intakes (RNIs) for the different population groups. We report on the nutrient profiles from our analysis of the pooled and age-matched data as well as sensory analysis and conclude that locally produced FMM foods can complement local diets and contribute significantly to meeting nutrient needs among vulnerable groups in food-insecure environments. Key words: food multimix, candidate foods, sustainable, food security, resource-poor, nutrition interventions.
    • Building systemic capacity for Nutrition: Training towards a professionalised workforce for Africa.

      Ellahi, Basma; Annan, Reginald; Sarkar, Swrajit; Amuna, Paul; Jackson, Alan A.; University of Chester; University of Kumasi; University of Central Lancashire; University of Greenwich; University of Southampton (Cambridge University Press, 2015-06-15)
      The fundamental role played by good nutrition in enabling personal, social and economic development is now widely recognised as presenting a fundamental global challenge that has to be addressed if major national and international problems are to be resolved in the coming decades. The recent focus provided by the Millennium Development Goals and the Scaling-Up-Nutrition (SUN) Movement has been towards reducing the extent of nutrition-related malnutrition in high burden countries. This has served to emphasise that there is a problem of inadequate professional capacity in nutrition that is sufficiently widespread to severely limit all attempts at the effective delivery and sustainability of nutrition-related and nutrition-enabling interventions that have impact at scale. Many high burden countries are in sub-Saharan Africa where there is a high dependency on external technical support to address nutrition-related problems. We have sought to explore the nature and magnitude of the capacity needs with a particular focus on achieving levels of competency within standardised professional pre-service training which is fit for purpose to meet the objectives within the Scaling-Up-Nutrition movement in Africa. We review our experience of engaging with stakeholders through workshops and a gap analysis of the extent of the problem to be addressed, and a review of current efforts in Africa. We conclude that there are high aspirations but severely limited human resource and capacity for training that is fit-for-purpose at all skill levels in nutrition-related subjects in Africa. There are no structured or collaborative plans within professional groups to address the wide gap between what is currently available, the ongoing needs and the future expectations for meeting local technical and professional capability. Programmatic initiatives encouraged by agencies and other external players, will need to be matched by improved local capabilities to address the serious efforts required to meet the needs for sustained improvements related to Scaling-Up-Nutrition in high burden countries. Importantly, there are pockets of effort which need to be encouraged within a context in which experience can be shared and mutual support provided.
    • Decreasing physical activity levels across religious Sikh male South asian migrant population in Kent, UK: A public health concern

      Sarkar, Swrajit; Ellahi, Basma; Zotor, Francis B.; Amuna, Paul; Leeds Trinity University; University of Chester; University of Health and Allied Sciences; University of Greenwich (SAGE, 2017-10-09)
      Physical activity (PA) plays a crucial role in reducing the risk of non-communicable diseases (NCDs). We investigated intergenerational physical activity level (PAL) among first and second generation Sikh Punjabi male subjects (n=137), recruited from two Sikh temples in Medway, UK. Employing a cross sectional survey PA was quantified using the validated Global PA Questionnaire (GPAQ). Data were analysed using SPSS 20 and Epi Info software. 91% of the subjects were classified as overweight. Mean physical activity level (PAL) range was sedentary to low levels of PA (1.45 – 1.60). Comparisons between first and second generation Punjabi male subjects showed that the two groups are equally culpable in not engaging in work-related or recreational PA, but for the second generation this is significantly lower. Low PAL is a contributory factor to increased risk and prevalence of NCDs among this population and a public health concern. Efforts to increase PA in this group should continue.
    • Food supplementation among HIV-infected adults in Sub-Saharan Africa: Impact on treatment adherence and weight gain

      Audain, Keiron A.; Zotor, Francis B.; Amuna, Paul; Ellahi, Basma; University of KwaZulu Natal ; University of Health and Allied Sciences, Ghana ; University of Greenwich ; University of Chester (The Nutrition Society, 2015-03-12)
      Sub-Saharan Africa has the highest proportion of undernourished people in the world, along with the highest number of people living with HIV and AIDS. Thus, as a result of high levels of food insecurity many HIV patients are also undernourished. The synergism between HIV and undernutrition leads to poor treatment adherence and high mortality rates. Undernutrition has a debilitating effect on the immune system due to key nutrient deficiencies and the overproduction of reactive species (oxidative stress), which causes rapid HIV progression and the onset of AIDS. Therapeutic food supplementation used in the treatment of severe acute malnutrition is being applied to HIV palliative care; however, little biochemical data exist to highlight its impact on oxidative stress and immune recovery.
    • Maternal nutritional status, food intake and pregnancy weight gain in Nepal

      Acharya, Ojaswi; Zotor, Francis B.; Chaudhary, Pushpa; Amuna, Paul; Ellahi, Basma; Action Contre La Faim ; University of Health and Allied Sciences, Hohoe, Ghana ; Nepal Society of Obstetricians and Gynecologists ; University of Greenwich ; University of Chester (SAGE, 2016-03-07)
      Poor maternal nutrition during pregnancy may predispose to intrauterine growth restriction (IUGR), immunological and metabolic adaptations which manifest as low birth weight and increase the risk of adult non-communicable disease. This study examined the relationships between maternal nutritional status, food intake and pregnancy weight gain (PWG) which may account for risk of low birth weight (LBW) in Nepal.