Background: School feeding offers an excellent opportunity for targeted intervention to students ... more 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 c...
Background: Middle childhood and adolescence are critical times for the growth, development, and ... more Background: Middle childhood and adolescence are critical times for the growth, development, and establishment of healthy eating habits. The Europe and Central Asia (ECA) region has been through economic and nutrition transitions over the past 20 years, which are likely to have affected the nutritional status of this group. Objective: This review aimed to collate data on the nutritional status and dietary patterns of school-aged children (SAC) and adolescents (5-19 years) across the ECA region in order to inform policy and programming decisions. Methods: A systematic search of the literature in Pubmed, Cochrane, and ScienceDirect databases was conducted (April 2019), complemented by a systematic review of nationally representative surveys. Inclusion criteria were any data on micronutrient deficiencies, overweight, stunting, wasting, thinness, or dietary patterns in SAC and adolescents in the 21 UNICEF-defined countries of ECA, published since the year 2000. Results: Results included 134 published papers and 6 sources of survey data. The majority of studies were conducted in Turkey (56%), with all other countries having fewer than 10 studies each; 8 countries in the region having no studies on this age group at all. The most significant nutrition issue was overweight and obesity. Micronutrient deficiencies, particularly anemia, emerge as a further challenge. Dietary patterns were worse in urban areas and boys. Conclusions: The findings of this review suggest that there are 3 critical areas that need immediate attention: the promotion of healthy diets and physical activity to address high levels of overweight/obesity, anemia prevention efforts, and addressing the considerable data gaps for SAC and adolescent nutrition.
Current data gaps in adolescent nutrition data 11 Policies, strategies and guidelines 12 Defining... more Current data gaps in adolescent nutrition data 11 Policies, strategies and guidelines 12 Defining the adolescent period 12 Existing policies and guidelines targeting adolescents 13 Interventions and programmes 13 WFP nutrition programming for adolescents 16 Study limitations 14 Conclusion and recommendations 19 References 21 Annexes 24 Contents Students at Gurumu Koysha primary and secondary school gather to learn about the nutritional values that various types of foods can provide for their health, In order to map global adolescent nutrition research, policies, interventions, data gaps and experiences, we undertook a survey of stakeholders with the aim of highlighting positive examples and to call for action in filling any identified gaps. Methods State of the world's children 2019 Adolescents' Workshops held in Shebedino woreda in the Southern Nations, Nationalities, and Peoples' Region of Ethiopia on
Agriculture in West Africa faces the challenge of meeting the rising demand for food as national ... more Agriculture in West Africa faces the challenge of meeting the rising demand for food as national incomes and populations increase while production becomes more uncertain due to climate change. Crop production models can provide helpful information on agricultural yields under a range of climate change scenarios and on the impact of adaptation strategies. Here, we report a systematic review of the impact of climate change on the yield of major staple crops in West Africa. Unlike earlier reviews we pay particular attention to the potential of common agricultural adaptation strategies (such as optimised planting dates, use of fertilisers and climate-resilient crop varieties) to mitigate the effects of climate change on crop yields. We systematically searched two databases for literature published between 2005 and 2020 and identified 35 relevant studies. We analysed yield changes of major staple crops (maize, sorghum, rice, millet, yam, cassava and groundnuts) caused by different climate change and field management scenarios. Yields declined by a median of 6% (−8% to +2% depending on the crop) due to climate change in all scenarios analysed. We show that the common adaptation strategies could increase crop yields affected by climate change by 13% (−4% to +19% depending on the strategy) as compared to business-as-usual field management practices, and that optimised planting dates and cultivars with longer crop cycle duration could in fact offset the negative effects of climate change on crop yields. Increased fertiliser use has not mitigated the impact of climate change on crops but could substantially increase yields now and in the future. Our results suggest that a combination of increased fertiliser use and adopting cropping practices that take advantage of favourable climate conditions have great potential to protect and enhance future crop production in West Africa.
Introduction Despite the gains on exclusive breastfeeding (EBF), recent nationwide surveys have c... more Introduction Despite the gains on exclusive breastfeeding (EBF), recent nationwide surveys have consistently revealed a decline in EBF rates in Ghana. The World Food Programme implemented an intervention for Enhanced Nutrition and Value Chain (ENVAC) which was based on three pillars including pregnant women, lactating women, adolescent and children under two years old being beneficiaries of the third pillar since the first 1000 days are critical for averting malnutrition. The social behavior change communication (SBCC) interventions implemented as part of this project have a potential to increase EBF among beneficiaries but this has not been measured. Therefore, this study assessed the prevalence of EBF practice among mothers with children under two years old who were beneficiaries of the ENVAC project and its associated factors in northern Ghana. Methods This was a cross-sectional study involving 339 mother-child pairs in two districts of the northern region of Ghana. Participants ...
Purpose A lack of data, intervention studies, policies, and targets for nutrition in school-age c... more Purpose A lack of data, intervention studies, policies, and targets for nutrition in school-age children (SAC) and adolescents (5-19 years) is hampering progress towards tackling malnutrition. To stimulate and guide further research, this study generated a list of research priorities. Methods Using the Child Health and Nutrition Research Initiative (CHNRI) method, a list of 48 research questions was compiled and questions were scored against defined criteria using a stakeholder survey. Questions covered all forms of malnutrition, including micronutrient deficiencies, thinness, stunting, overweight/obesity, and suboptimal dietary quality. The context was defined as research focused on SAC and adolescents, 5 to 19 years old, in low-and middle-income countries, that could achieve measurable results in reducing the prevalence of malnutrition in the next 10 years. Results Between 85 and 101 stakeholders responded per question. Respondents covered a broad geographical distribution across ...
BackgroundThe coexistence of under- and overnutrition is of increasing public health concern in T... more BackgroundThe coexistence of under- and overnutrition is of increasing public health concern in The Gambia. Fruits, vegetables and pulses are essential to healthy and sustainable diets, preventing micronutrient deficiencies and non-communicable diseases, while cereals significantly contribute to energy intake. However, environmental changes are predicted to intensify, reducing future yields of these crops if agricultural productivity and resilience are not improved. The Gambia is highly climate-vulnerable and import-dependent, but the extent of its reliance on other climate-vulnerable countries for its supply of nutritionally important crops is currently unknown.MethodsWe used United Nations Food and Agriculture Organization data, with novel origin-tracing algorithms applied, to analyse The Gambia's supply of cereals, fruits, vegetables and pulses between 1988 and 2018. The climate vulnerability of countries was assessed using Notre Dame Global Adaptation Initiative (ND-GAIN) in...
Identifying and assessing adaptation options are key pre-requisite steps to adaptation prioritiza... more Identifying and assessing adaptation options are key pre-requisite steps to adaptation prioritization and effective adaptation planning. In this paper, we presented a systematic approach for adaptation stocktaking, combining a systematic mapping and an outcome-oriented and evidence-based assessment, illustrated using the case of The Gambia. This study systematically mapped 24 adaptation options that can potentially inform adaptation planning in The Gambia agriculture and food systems and assessed how the identified options contribute to the pillars of Climate-Smart Agriculture. Because of the paucity of evidence sources from The Gambia, we collated evidence from both The Gambia and the West Africa region. We found that many of the documented options, such as climate-resilient crop varieties, crop diversification, climate information use, and weather indexed-based insurance have the potential to increase agricultural productivity and income while building resilience to climate change...
Climate change and environmental degradation are among the greatest threats to human health. Yout... more Climate change and environmental degradation are among the greatest threats to human health. Youth campaigners have very effectively focused global attention on the crisis, however children from the Global South are often under-represented (sometimes deliberately) in the dialogue. In The Gambia, West Africa, the impacts of climate change are already being directly experienced by the population, and this will worsen in coming years. There is strong government and community commitment to adapt to these challenges, as evidenced by The Gambia currently being the only country on target to meet the Paris agreement according to the Nationally Determined Contributions, but again children's voices are often missing-while their views could yield valuable additional insights. Here, we describe a "Climate Change Solutions Festival" that targeted and engaged school children from 13 to 18 years, and is to our knowledge, the first peerto-peer (and student-to-professional) learning festival on climate change solutions for students in The Gambia. The event gave a unique insight into perceived climate change problems and scalable, affordable and sometimes very creative solutions that could be implemented in the local area. Logistical and practical methods for running the festival are shared, as well as details on all solutions demonstrated in enough detail to be duplicated. We also performed a narrative review of the most popular stalls to explore the scientific basis of these solutions and discuss these in a global context. Overall, we find extremely strong, grassroots and student engagement in the Gambia and clear evidence of learning about climate change and the impacts of environmental degradation more broadly. Nevertheless, we reflect that in order to enact these proposed local solutions further steps to evaluate acceptability of adoption, feasibility within the communities, cost-benefit analyses and ability to scale solutions are needed. This could be the focus of future experiential learning activities with students and partnering stakeholders.
Facilitating dietary change is pivotal to improving population health, increasing food system res... more Facilitating dietary change is pivotal to improving population health, increasing food system resilience, and minimizing adverse impacts on the environment, but assessment of the current ‘status-quo’ and identification of bottlenecks for improvement has been lacking to date. We assessed deviation of the Gambian diet from the EAT-Lancet guidelines for healthy and sustainable diets and identified leverage points to improve nutritional and planetary health. We analysed the 2015/16 Gambian Integrated Household Survey dataset comprising food consumption data from 12 713 households. Consumption of different food groups was compared against the EAT-Lancet reference diet targets to assess deviation from the guidelines. We computed a ‘sustainable and healthy diet index (SHDI)’ based on deviation of different food groups from the EAT-Lancet recommendations and modelled the socio-economic and geographic determinants of households that achieved higher scores on this index, using multivariable m...
Background: Typical complementary foods in developing countries are often inadequate in multiple ... more Background: Typical complementary foods in developing countries are often inadequate in multiple micronutrients. One way of preventing micronutrient deficiency among infants and young children (IYC) is to feed them a variety of nutrient dense foods. The use of commercial infant cereals (CIC) as complementary food is increasing in Ghana. However, it is unknown whether giving CIC may discourage inclusion of other locally available and nutritious foods as mothers may hold the notion that CIC is superior. This study therefore examined the use of CIC as complementary food, the micronutrient intake from CIC and reasons for its use. Methods: A cross-sectional study was conducted involving mothers with IYC aged 6-23 months who give CIC as complementary food. Questionnaires were administered to estimate the usual daily frequencies and quantities of CIC. Micronutrient intakes from CIC were calculated. We also calculated the proportion of the recommended nutrient intake (RNI) contributed by micronutrients from CIC. Results: Of the 384 children sampled, 64.6% were aged 13-23 months and 50.3% were females. More than half of the mothers earned income through trading (55.2%) and nearly one quarter of them had senior high school education (24. 7%). Majority of the children consumed 3-4 tablespoons (52.3%) of CIC in a feeding moment. Younger children (6-12 months) were served CIC more frequent than older children (13-23 months). The mean ± SD of micronutrients from CIC were 6.
Objective: Height data is not useful immediately without further processing. The Stunting mat was... more Objective: Height data is not useful immediately without further processing. The Stunting mat was designed to stunting. However, the mat has not been validated for use in Ghana. This study compared stunting measured with the mat and stunting measured following the WHO recommended procedure. We sampled 163 children aged 6-24-m in the Bono region of Ghana. We compared stunting prevalence measured with the mat and WHO recommended procedure. We also explored the acceptability and interpretability of the two procedures among mothers and healthcare givers. Results: The prevalence of stunting was 3.7% and 11.7% using the Stunting mat and WHO procedures respectively. However, in younger aged children, the Stunting mat was more accurate in detecting stunting: Both healthcare workers and caregivers found it easy to interpret the stunting status of children using the Stunting mat. Therefore, we can conclude that the Stunting mat was less sensitive at detecting child stunting compared to the current gold way of measuring stunting in younger children. There are possibilities to improve the accuracy and utility of the Stunting mat for measuring stunting in lowresource settings by redesigning the mat to be more age appropriate.
Objectives We assessed deviation of the Gambian diet from the EAT-Lancet guidelines for healthy a... more Objectives We assessed deviation of the Gambian diet from the EAT-Lancet guidelines for healthy and sustainable diets and identified leverage points to improve nutritional and planetary health. Methods We performed secondary analyses using the recent Integrated Household Survey dataset comprising food consumption data from 12,713 households. Consumption of different food groups were compared against EAT-Lancet reference diet targets to assess deviation from the guidelines. We computed a “sustainable and healthy diet index” based on deviation of different food groups from the EAT-Lancet recommendations and modelled the socio-economic and geographic determinants of households that achieved higher scores on this index, using multivariable mixed effects regression. Results The average Gambian diet had very low adherence to EAT-Lancet recommendations. The diet was dominated by refined grains and added sugars consumption which exceed the recommendations. Consumption of important food grou...
The crop model CERES-Barley was used to assess the impacts of increased concentration of atmosphe... more The crop model CERES-Barley was used to assess the impacts of increased concentration of atmospheric CO 2 on growth and development of the most important spring cereal in Central and Western Europe, i.e., spring barley, and to examine possible adaptation strategies. Three experimental regions were selected to compare the climate change impacts in various climatic and pedological conditions. The analysis was based on multi-year crop model simulations run with daily weather series obtained by a stochastic weather generator and included two yield levels: stressed yields and potential yields. Four climate change scenarios based on global climate models and representing 2 × CO 2 climate were applied. Results: (i) The crop model is suitable for use in the given environment, e.g., the coefficient of determination between the simulated and experimental yields equals 0.88. (ii) The indirect effect related to changed weather conditions is mostly negative. Its magnitude ranges from-19% to +5% for the four scenarios applied at the three regions. (iii) The magnitude of the direct effect of doubled CO 2 on the stressed yields for the three test sites is 35-55% in the present climate and 25-65% in the 2 × CO 2 climates. (iv) The stressed yields would increase in 2 × CO 2 conditions by 13-52% when both direct and indirect effects were considered. (v) The impacts of doubled CO 2 on potential yields are more uniform throughout the localities in comparison with the stressed yields. The magnitude of the indirect and direct effects ranges from-1 to-9% and from +31 to +33%, respectively. Superposition of both effects results in 19-30% increase of the potential yields. (vi) Application of the earlier planting date (up to 60 days) would result in 15-22% increase of the yields in 2 × CO 2 conditions. (vii) Use of a cultivar with longer vegetation duration would bring 1.5% yield increase per one extra day of the vegetation season. (viii) The initial water content in the soil water profile proved to be one of the key elements determining the spring barley yield. It causes the yields to increase by 54-101 kg.ha −1 per 1% increase of the available soil water content on the sowing day. Electronic versions of the text (Word 2000) and figures (GIFs) are available upon request from the corresponding author.
Background: School feeding offers an excellent opportunity for targeted intervention to students ... more 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 c...
Background: Middle childhood and adolescence are critical times for the growth, development, and ... more Background: Middle childhood and adolescence are critical times for the growth, development, and establishment of healthy eating habits. The Europe and Central Asia (ECA) region has been through economic and nutrition transitions over the past 20 years, which are likely to have affected the nutritional status of this group. Objective: This review aimed to collate data on the nutritional status and dietary patterns of school-aged children (SAC) and adolescents (5-19 years) across the ECA region in order to inform policy and programming decisions. Methods: A systematic search of the literature in Pubmed, Cochrane, and ScienceDirect databases was conducted (April 2019), complemented by a systematic review of nationally representative surveys. Inclusion criteria were any data on micronutrient deficiencies, overweight, stunting, wasting, thinness, or dietary patterns in SAC and adolescents in the 21 UNICEF-defined countries of ECA, published since the year 2000. Results: Results included 134 published papers and 6 sources of survey data. The majority of studies were conducted in Turkey (56%), with all other countries having fewer than 10 studies each; 8 countries in the region having no studies on this age group at all. The most significant nutrition issue was overweight and obesity. Micronutrient deficiencies, particularly anemia, emerge as a further challenge. Dietary patterns were worse in urban areas and boys. Conclusions: The findings of this review suggest that there are 3 critical areas that need immediate attention: the promotion of healthy diets and physical activity to address high levels of overweight/obesity, anemia prevention efforts, and addressing the considerable data gaps for SAC and adolescent nutrition.
Current data gaps in adolescent nutrition data 11 Policies, strategies and guidelines 12 Defining... more Current data gaps in adolescent nutrition data 11 Policies, strategies and guidelines 12 Defining the adolescent period 12 Existing policies and guidelines targeting adolescents 13 Interventions and programmes 13 WFP nutrition programming for adolescents 16 Study limitations 14 Conclusion and recommendations 19 References 21 Annexes 24 Contents Students at Gurumu Koysha primary and secondary school gather to learn about the nutritional values that various types of foods can provide for their health, In order to map global adolescent nutrition research, policies, interventions, data gaps and experiences, we undertook a survey of stakeholders with the aim of highlighting positive examples and to call for action in filling any identified gaps. Methods State of the world's children 2019 Adolescents' Workshops held in Shebedino woreda in the Southern Nations, Nationalities, and Peoples' Region of Ethiopia on
Agriculture in West Africa faces the challenge of meeting the rising demand for food as national ... more Agriculture in West Africa faces the challenge of meeting the rising demand for food as national incomes and populations increase while production becomes more uncertain due to climate change. Crop production models can provide helpful information on agricultural yields under a range of climate change scenarios and on the impact of adaptation strategies. Here, we report a systematic review of the impact of climate change on the yield of major staple crops in West Africa. Unlike earlier reviews we pay particular attention to the potential of common agricultural adaptation strategies (such as optimised planting dates, use of fertilisers and climate-resilient crop varieties) to mitigate the effects of climate change on crop yields. We systematically searched two databases for literature published between 2005 and 2020 and identified 35 relevant studies. We analysed yield changes of major staple crops (maize, sorghum, rice, millet, yam, cassava and groundnuts) caused by different climate change and field management scenarios. Yields declined by a median of 6% (−8% to +2% depending on the crop) due to climate change in all scenarios analysed. We show that the common adaptation strategies could increase crop yields affected by climate change by 13% (−4% to +19% depending on the strategy) as compared to business-as-usual field management practices, and that optimised planting dates and cultivars with longer crop cycle duration could in fact offset the negative effects of climate change on crop yields. Increased fertiliser use has not mitigated the impact of climate change on crops but could substantially increase yields now and in the future. Our results suggest that a combination of increased fertiliser use and adopting cropping practices that take advantage of favourable climate conditions have great potential to protect and enhance future crop production in West Africa.
Introduction Despite the gains on exclusive breastfeeding (EBF), recent nationwide surveys have c... more Introduction Despite the gains on exclusive breastfeeding (EBF), recent nationwide surveys have consistently revealed a decline in EBF rates in Ghana. The World Food Programme implemented an intervention for Enhanced Nutrition and Value Chain (ENVAC) which was based on three pillars including pregnant women, lactating women, adolescent and children under two years old being beneficiaries of the third pillar since the first 1000 days are critical for averting malnutrition. The social behavior change communication (SBCC) interventions implemented as part of this project have a potential to increase EBF among beneficiaries but this has not been measured. Therefore, this study assessed the prevalence of EBF practice among mothers with children under two years old who were beneficiaries of the ENVAC project and its associated factors in northern Ghana. Methods This was a cross-sectional study involving 339 mother-child pairs in two districts of the northern region of Ghana. Participants ...
Purpose A lack of data, intervention studies, policies, and targets for nutrition in school-age c... more Purpose A lack of data, intervention studies, policies, and targets for nutrition in school-age children (SAC) and adolescents (5-19 years) is hampering progress towards tackling malnutrition. To stimulate and guide further research, this study generated a list of research priorities. Methods Using the Child Health and Nutrition Research Initiative (CHNRI) method, a list of 48 research questions was compiled and questions were scored against defined criteria using a stakeholder survey. Questions covered all forms of malnutrition, including micronutrient deficiencies, thinness, stunting, overweight/obesity, and suboptimal dietary quality. The context was defined as research focused on SAC and adolescents, 5 to 19 years old, in low-and middle-income countries, that could achieve measurable results in reducing the prevalence of malnutrition in the next 10 years. Results Between 85 and 101 stakeholders responded per question. Respondents covered a broad geographical distribution across ...
BackgroundThe coexistence of under- and overnutrition is of increasing public health concern in T... more BackgroundThe coexistence of under- and overnutrition is of increasing public health concern in The Gambia. Fruits, vegetables and pulses are essential to healthy and sustainable diets, preventing micronutrient deficiencies and non-communicable diseases, while cereals significantly contribute to energy intake. However, environmental changes are predicted to intensify, reducing future yields of these crops if agricultural productivity and resilience are not improved. The Gambia is highly climate-vulnerable and import-dependent, but the extent of its reliance on other climate-vulnerable countries for its supply of nutritionally important crops is currently unknown.MethodsWe used United Nations Food and Agriculture Organization data, with novel origin-tracing algorithms applied, to analyse The Gambia's supply of cereals, fruits, vegetables and pulses between 1988 and 2018. The climate vulnerability of countries was assessed using Notre Dame Global Adaptation Initiative (ND-GAIN) in...
Identifying and assessing adaptation options are key pre-requisite steps to adaptation prioritiza... more Identifying and assessing adaptation options are key pre-requisite steps to adaptation prioritization and effective adaptation planning. In this paper, we presented a systematic approach for adaptation stocktaking, combining a systematic mapping and an outcome-oriented and evidence-based assessment, illustrated using the case of The Gambia. This study systematically mapped 24 adaptation options that can potentially inform adaptation planning in The Gambia agriculture and food systems and assessed how the identified options contribute to the pillars of Climate-Smart Agriculture. Because of the paucity of evidence sources from The Gambia, we collated evidence from both The Gambia and the West Africa region. We found that many of the documented options, such as climate-resilient crop varieties, crop diversification, climate information use, and weather indexed-based insurance have the potential to increase agricultural productivity and income while building resilience to climate change...
Climate change and environmental degradation are among the greatest threats to human health. Yout... more Climate change and environmental degradation are among the greatest threats to human health. Youth campaigners have very effectively focused global attention on the crisis, however children from the Global South are often under-represented (sometimes deliberately) in the dialogue. In The Gambia, West Africa, the impacts of climate change are already being directly experienced by the population, and this will worsen in coming years. There is strong government and community commitment to adapt to these challenges, as evidenced by The Gambia currently being the only country on target to meet the Paris agreement according to the Nationally Determined Contributions, but again children's voices are often missing-while their views could yield valuable additional insights. Here, we describe a "Climate Change Solutions Festival" that targeted and engaged school children from 13 to 18 years, and is to our knowledge, the first peerto-peer (and student-to-professional) learning festival on climate change solutions for students in The Gambia. The event gave a unique insight into perceived climate change problems and scalable, affordable and sometimes very creative solutions that could be implemented in the local area. Logistical and practical methods for running the festival are shared, as well as details on all solutions demonstrated in enough detail to be duplicated. We also performed a narrative review of the most popular stalls to explore the scientific basis of these solutions and discuss these in a global context. Overall, we find extremely strong, grassroots and student engagement in the Gambia and clear evidence of learning about climate change and the impacts of environmental degradation more broadly. Nevertheless, we reflect that in order to enact these proposed local solutions further steps to evaluate acceptability of adoption, feasibility within the communities, cost-benefit analyses and ability to scale solutions are needed. This could be the focus of future experiential learning activities with students and partnering stakeholders.
Facilitating dietary change is pivotal to improving population health, increasing food system res... more Facilitating dietary change is pivotal to improving population health, increasing food system resilience, and minimizing adverse impacts on the environment, but assessment of the current ‘status-quo’ and identification of bottlenecks for improvement has been lacking to date. We assessed deviation of the Gambian diet from the EAT-Lancet guidelines for healthy and sustainable diets and identified leverage points to improve nutritional and planetary health. We analysed the 2015/16 Gambian Integrated Household Survey dataset comprising food consumption data from 12 713 households. Consumption of different food groups was compared against the EAT-Lancet reference diet targets to assess deviation from the guidelines. We computed a ‘sustainable and healthy diet index (SHDI)’ based on deviation of different food groups from the EAT-Lancet recommendations and modelled the socio-economic and geographic determinants of households that achieved higher scores on this index, using multivariable m...
Background: Typical complementary foods in developing countries are often inadequate in multiple ... more Background: Typical complementary foods in developing countries are often inadequate in multiple micronutrients. One way of preventing micronutrient deficiency among infants and young children (IYC) is to feed them a variety of nutrient dense foods. The use of commercial infant cereals (CIC) as complementary food is increasing in Ghana. However, it is unknown whether giving CIC may discourage inclusion of other locally available and nutritious foods as mothers may hold the notion that CIC is superior. This study therefore examined the use of CIC as complementary food, the micronutrient intake from CIC and reasons for its use. Methods: A cross-sectional study was conducted involving mothers with IYC aged 6-23 months who give CIC as complementary food. Questionnaires were administered to estimate the usual daily frequencies and quantities of CIC. Micronutrient intakes from CIC were calculated. We also calculated the proportion of the recommended nutrient intake (RNI) contributed by micronutrients from CIC. Results: Of the 384 children sampled, 64.6% were aged 13-23 months and 50.3% were females. More than half of the mothers earned income through trading (55.2%) and nearly one quarter of them had senior high school education (24. 7%). Majority of the children consumed 3-4 tablespoons (52.3%) of CIC in a feeding moment. Younger children (6-12 months) were served CIC more frequent than older children (13-23 months). The mean ± SD of micronutrients from CIC were 6.
Objective: Height data is not useful immediately without further processing. The Stunting mat was... more Objective: Height data is not useful immediately without further processing. The Stunting mat was designed to stunting. However, the mat has not been validated for use in Ghana. This study compared stunting measured with the mat and stunting measured following the WHO recommended procedure. We sampled 163 children aged 6-24-m in the Bono region of Ghana. We compared stunting prevalence measured with the mat and WHO recommended procedure. We also explored the acceptability and interpretability of the two procedures among mothers and healthcare givers. Results: The prevalence of stunting was 3.7% and 11.7% using the Stunting mat and WHO procedures respectively. However, in younger aged children, the Stunting mat was more accurate in detecting stunting: Both healthcare workers and caregivers found it easy to interpret the stunting status of children using the Stunting mat. Therefore, we can conclude that the Stunting mat was less sensitive at detecting child stunting compared to the current gold way of measuring stunting in younger children. There are possibilities to improve the accuracy and utility of the Stunting mat for measuring stunting in lowresource settings by redesigning the mat to be more age appropriate.
Objectives We assessed deviation of the Gambian diet from the EAT-Lancet guidelines for healthy a... more Objectives We assessed deviation of the Gambian diet from the EAT-Lancet guidelines for healthy and sustainable diets and identified leverage points to improve nutritional and planetary health. Methods We performed secondary analyses using the recent Integrated Household Survey dataset comprising food consumption data from 12,713 households. Consumption of different food groups were compared against EAT-Lancet reference diet targets to assess deviation from the guidelines. We computed a “sustainable and healthy diet index” based on deviation of different food groups from the EAT-Lancet recommendations and modelled the socio-economic and geographic determinants of households that achieved higher scores on this index, using multivariable mixed effects regression. Results The average Gambian diet had very low adherence to EAT-Lancet recommendations. The diet was dominated by refined grains and added sugars consumption which exceed the recommendations. Consumption of important food grou...
The crop model CERES-Barley was used to assess the impacts of increased concentration of atmosphe... more The crop model CERES-Barley was used to assess the impacts of increased concentration of atmospheric CO 2 on growth and development of the most important spring cereal in Central and Western Europe, i.e., spring barley, and to examine possible adaptation strategies. Three experimental regions were selected to compare the climate change impacts in various climatic and pedological conditions. The analysis was based on multi-year crop model simulations run with daily weather series obtained by a stochastic weather generator and included two yield levels: stressed yields and potential yields. Four climate change scenarios based on global climate models and representing 2 × CO 2 climate were applied. Results: (i) The crop model is suitable for use in the given environment, e.g., the coefficient of determination between the simulated and experimental yields equals 0.88. (ii) The indirect effect related to changed weather conditions is mostly negative. Its magnitude ranges from-19% to +5% for the four scenarios applied at the three regions. (iii) The magnitude of the direct effect of doubled CO 2 on the stressed yields for the three test sites is 35-55% in the present climate and 25-65% in the 2 × CO 2 climates. (iv) The stressed yields would increase in 2 × CO 2 conditions by 13-52% when both direct and indirect effects were considered. (v) The impacts of doubled CO 2 on potential yields are more uniform throughout the localities in comparison with the stressed yields. The magnitude of the indirect and direct effects ranges from-1 to-9% and from +31 to +33%, respectively. Superposition of both effects results in 19-30% increase of the potential yields. (vi) Application of the earlier planting date (up to 60 days) would result in 15-22% increase of the yields in 2 × CO 2 conditions. (vii) Use of a cultivar with longer vegetation duration would bring 1.5% yield increase per one extra day of the vegetation season. (viii) The initial water content in the soil water profile proved to be one of the key elements determining the spring barley yield. It causes the yields to increase by 54-101 kg.ha −1 per 1% increase of the available soil water content on the sowing day. Electronic versions of the text (Word 2000) and figures (GIFs) are available upon request from the corresponding author.
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