• 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.
    • 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.
    • Exploring the health status of older persons in Sub Saharan Africa

      Audain, Keiron A.; Carr, Michelle; Dikmen, Derya; Zotor, Francis B.; Ellahi, Basma; University of Zambia; University of Chester; Hacettepe University; University of Health and Allied Science; University of Chester (Cambridge University Press, 2017-05-10)
      Sub-Saharan Africa has traditionally had a low life expectancy due to the onslaught of the HIV epidemic, high levels of chronic diseases, injuries, conflict and undernutrition. Therefore, research into public health concerns of older persons has largely been overlooked. With a growing population, the roll-out of antiretroviral treatment, and the effects of globalisation; Sub-Saharan Africa is experiencing an increase in the number of people over 50 years of age as well as an increase in the prevalence of non-communicable diseases. The aim of this review is to highlight available research on the health status of older persons in Sub-Saharan Africa, and to identify the current gaps that warrant further investigation. A literature search was conducted across multiple databases to identify studies in Sub-Saharan Africa on older persons (aged 50 years and older) related to health indicators including nutritional status, non-communicable diseases and HIV burden. Whilst it was concluded that older persons are at an increased risk of poor health, it was also determined that significant gaps exist in this particular area of research; namely nutrient deficiency prevalence. Resources should be directed towards identifying the health concerns of older persons and developing appropriate interventions.
    • 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.
    • Knowledge and Determinants of Fruit and Vegetable Consumption among Adults in Hohoe Municipality, Ghana

      Awuni, Thomas K.; Kye-Duodu, Gideon; Duodu, Charles; Zotor, Francis B.; Ellahi, Basma; Ghana Health Service, Municipal Health Directorate, Elmina, Ghana 2 Department of Epidemiology and Biostatistics, University of Health and Allied Sciences, Ho, Ghana 3 Ghana Health Service, Volta Regional Health Directorate, Ho, Ghana 4 Department of Family and Community Health, University of Health and Allied Sciences, Ho, Ghana 5 Faculty of Health and Social Care, University of Chester, Chester, UK (scholink, 2017-12-04)
      The World Health Organization (WHO) recommends that a person consumes at least 400g of Fruit and Vegetable (FV) daily to prevent chronic disease risk. We assessed knowledge of current WHO guidelines and other determinants of FV intake among adults (≥ 18 years, n = 397) in Hohoe Municipality, Ghana. Face-to-face interviews using a questionnaire adopted from WHO Risk Factor Surveillance System were undertaken. Knowledge of FV daily servings and determinants of intake were evaluated by descriptive statistics and binary logistic regression. There was a 99.2% response rate with approximately 9% of participants correctly stating the WHO daily recommended amount (P = .296). Most (54%) of respondents’ FV intake was affected by unavailability of desired choice (P = .050). Odd of inadequate consumption for persons aware of adequate amount was 1.97 (95% CI: 0.64, 6.05, P = .234) higher than persons without awareness. Participants with problems accessing their desired choice of FV had 0.59 odds (95% CI: 0.36, 0.95, P = .030) of consuming inadequate amount compared to those with easy access. Adequate FV intake depends on availability of consumer preference regardless of knowledge of recommendations. Individual FV cultivation is relevant for availability of preferred choice and adequate consumption for NCDs risk reductions among Ghanaians.
    • 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.