BMC Nutrition最新文献

Background: Food safety is vital for public health in Africa, where foodborne diseases pose significant risks. Despite the importance of proper food handling, comprehensive data on household food safety practices across the continent is scarce. Various socioeconomic, cultural, and environmental factors may influence these practices, but their interplay is still unclear.

Aim: This systematic review and meta-analysis sought to synthesize evidence on household food safety practices in Africa, with a focus on identifying the determinant factors influencing these behaviors.

Methods: Literature searches were conducted using PubMed, Embase, African Journals Online, and ScienceDirect, along with Google Scholar and citations from other studies. Keywords and medical subject-heading terms related to the study title were used. Data extraction was performed using Microsoft Excel, and meta-analysis was conducted with Stata version 18.0 using a random effect model.

Results: Nineteen studies were included in the systematic review, with ten meeting the criteria for meta-analysis. Overall, the pooled prevalence of respondents showing good food safety practices was 54% (95% CI: 46% to 62%). In comparison, the prevalence of good food hygiene practices varied widely, ranging from 17.6% to 86.0%. Several key factors were identified as influencing these practices, including disease awareness, the availability of latrines, handwashing facilities, liquid waste disposal pits, and workload. Furthermore, higher education levels, improved wealth status, good knowledge, and positive attitudes towards food safety were found to be crucial for enhancing household food safety practices.

Conclusion: Half of the households in seven African countries did not practice proper food hygiene and safety. Key factors influencing practices included disease awareness, access to sanitation facilities, and workload, while understanding and positive attitudes towards food safety were essential for improvement.

Objective: Kidney health and dietary protein consumption are incompatible. This study aimed to examine the association between different types of proteins (total, animal, and plant) and chronic kidney disease (CKD).

Methods: A comprehensive literature search was conducted in PubMed, Web of Science, and Scopus for articles published up to May 7, 2023. We included prospective cohort studies that reported the association between dietary intake of total, animal, or plant proteins and the risk of CKD, based on predefined eligibility criteria.

Results: Ten prospective cohort studies involving 218,741 participants and 10,794 CKD events were included. Meta-analysis indicated that higher intake of animal protein (relative risk [RR] = 0.87, 95% CI: 0.77-0.97; GRADE: high certainty) and plant protein (RR = 0.81, 95% CI: 0.67-0.98; GRADE: moderate certainty) was significantly associated with a reduced risk of CKD. However, no significant association was found between total protein intake and CKD risk (RR = 0.95, 95% CI: 0.75-1.19; GRADE: low certainty). A significant linear dose-response relationship was observed between plant protein intake and lower CKD risk (P < 0.001).

Conclusion: In conclusion, while no significant association was observed between total protein intake and CKD risk, both animal and plant protein consumption were associated with a reduced risk. These findings highlight the potential protective role of protein sources in kidney health. Future research should explore the underlying mechanisms of these associations and examine the effects of specific protein sources in diverse populations over longer follow-up periods.

Background: Nutritional management strategies for long-term ICU patients remain insufficiently established. This study evaluated the association between implementing an enhanced nutrition support system and enteral nutrition (EN) adequacy and related care indicators in patients with prolonged ICU stay.

Methods: In this single-center retrospective study, 85 adults with ICU stay ≥ 14 days were assigned to the conventional (January 2019 to October 2021; n = 48) or enhanced (November 2021 to March 2024; n = 37) groups based on hospital adoption of the enhanced nutrition support system, without patient-level prospective assignment or randomization. During the enhanced period, this system-comprising full-time dietitian assignment, standardized EN protocols for oral and tube feeding, systematic nutritional assessment, and intolerance management-was provided as routine care from ICU day 1. All variables were retrospectively abstracted from electronic medical records. Primary outcomes were presence of EN on day 14 (oral and/or tube), presence of oral intake on day 14, and daily EN adequacy (energy and protein sufficiency) over ICU days 1-14. Secondary outcomes included ratio of central venous catheter (CVC) placement days, antibiotic administration days ratio, positive blood culture rates, and incidence of gastrointestinal intolerance symptoms (diarrhea, constipation, vomiting).

Results: On day 14, the enhanced group showed significantly higher rates of EN presence (78.4% vs. 52.1%, p = 0.013) and oral intake presence (35.1% vs. 12.5%, p = 0.013) than did the conventional group. Significant group-by-day interactions for energy and protein adequacy rates (both, p < 0.001) indicated steeper increases over time in the enhanced group. The median ratio of CVC placement days was lower in the enhanced group than in the conventional group (35.1% vs. 63.1%, p = 0.035). No significant differences were found between the groups in gastrointestinal intolerance symptoms, antibiotic administration days ratio, or positive blood culture rates.

Conclusions: Implementation of an enhanced nutrition support system was associated with higher EN adequacy, higher day-14 EN and oral intake rates, and lower CVC use in long-term ICU patients, without increasing gastrointestinal intolerance. These findings support the adoption of multidisciplinary, protocol-based nutrition support as a standard approach for ICU patients at high nutritional risk.

Background: Type 2 diabetes (T2D) is a global public health problem, and its prevalence in resource-poor countries like Nepal has been rapidly increasing. However, there is a lack of a contextual and consistently structured, guided approach tailored to the integrated management of T2D in Nepal. Therefore, this study aims to co-design a pathway and manual for a dietitian-led dietary approach to the management of T2D in Nepal.

Methods: The study used a co-design method guided by the "Design Thinking" approach. Data were collected through a purposively selected group of 14 participants who participated in a co-design workshop, and nine participants with whom qualitative interviews were conducted to validate the co-designed contents. Before conducting the co-design workshop, nineteen one-on-one consultative meetings were carried out with various stakeholders. The data analysis followed the content analysis technique and presented results under common broader themes.

Results: The results from the first part of a co-design workshop are presented under themes including complexities of diabetes management in the Nepalese context, social and behavioural challenges, dietary adherence challenges and service providers' responses, and treatment approaches. The results from the second part of the workshop are presented under the themes, including the pathway for the dietitian-led dietary approach for the management of diabetes and the contents and design of the Nutrition Education Manual for the management of T2D.

Conclusions: The pathway co-designed for integrated management of T2D offers a contextual framework for understanding the mechanisms of change underlying the integrated efforts in T2D management. At the same time, the Nutrition Education Manual provides practical guidance for promoting healthy dietary behaviours among patients with T2D.

Background: Consuming a healthy diet is among the essential ways to control hypertension. However, dietary adherence among patients with hypertension is low in Ethiopia, particularly in the current study area. Therefore, this study aimed to assess determinants of dietary adherence among patients with hypertension receiving outpatient treatment at public hospitals in the Gedeo Zone, southern Ethiopia, 2025.

Methods: An institution-based unmatched case‒control study supported by a phenomenological study design (convergent parallel study) was conducted among 369 (123 cases and 246 controls) patients with hypertension. A seven-item questionnaire with seven dietary components was used to assess dietary adherence among patients with hypertension. For the quantitative study, a stratified random sampling technique was used to allocate the study area, and then a simple random sampling technique was used to select the study participants. Statistical package for Social Science version 29 software was used to perform bivariable and multivariable logistic regression to test the associations between the dependent and independent variables. For the qualitative study, purposive selection was performed. After data transcription, ATLAS.ti 25 was used to code and analyse the data.

Result: A total of 369 (123 cases and 246 controls) study participants were enrolled. The dietary adherence was found to be better in older patients (> 59) (AOR = 3.62; 95% CI (1.14, 11.50), those who had no comorbidities (AOR = 3.28; 95% CI (1.04, 10.36), Patients with more than 2 years duration of hypertension (AOR = 3.29; 95% CI (1.47, 7.36), and those who had good knowledge about hypertension and healthy lifestyle (AOR = 1.214; 95% CI (1.03, 4.75)). However, it was lower in those who had not received nutritional education (AOR = 0.32; 95% CI (0.13, 0.78)).

Conclusion: Age, not receiving nutritional education, Absence of comorbidity, Duration of hypertension, and Knowledge about hypertension and healthy lifestyles were found to be determinants of dietary adherence; hence, interventions focusing on the above determinants promoting adherence and patients' health support should be implemented.

Background: Despite Ethiopia's agricultural potential and policy efforts, food insecurity and malnutrition remain major challenges, particularly among children. The Ethiopian government has launched programs to improve food security and nutrition in the country. However, the effectiveness of these initiatives in addressing child malnutrition and food insecurity has not been comprehensively reviewed yet.

Methods: A systematic review following the PRISMA guidelines was conducted to evaluate the impact of food and nutrition programs on child nutrition and household food security in Ethiopia. A comprehensive search of PubMed, Scopus, Web of Science, and Google Scholar identified relevant studies published between 2015 and March 2025. Fourteen studies focusing on various program types in the country were included.

Results: Studies have reported inconsistent results regarding the effectiveness of food and nutrition programs in improving child anthropometry and household food security outcomes. Combined programs positively affected child nutrition, including reduced stunting and wasting, whereas single programs had limited impact. Program effectiveness varies by geography, seasonality, and socioeconomic conditions. Multicomponent programs, women's empowerment, and community engagement were critical to effectiveness.

Conclusion: This review highlights the importance of multi-component interventions in enhancing child nutrition and food security. Policymakers should design context-specific interventions that address geographical, seasonal, and socioeconomic variation. Future programs should focus on long-term sustainability, maternal and child health education, improved access to nutritious foods, strengthening social safety nets, and integrating programs. Enhanced community engagement and further investigation into the long-term effects of these programs are crucial for their efficacy and resilience against climate change and economic challenges.

Background: Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is an autosomal recessive disorder of ß-oxidation. A loss of enzyme function results in impaired breakdown of medium-chain fatty acids. The main treatment involves a dietetic approach to ensure adequate food intake and avoiding fasting. Diseases treated with a strict diet during childhood are often associated with eating problems. However, research in this area is very limited. This exploratory observational study aimed to examine the effects of dietary management and the underlying recommendations for MCADD on eating behaviour, as well as their subsequent impact on family life.

Methods: Paediatric and young adult patients (age 8-25) with MCADD and their caregivers at the University Hospital Muenster were included. A descriptive semi-quantitative study design incorporating qualitative elements was chosen. A novel combination of questions from validated questionnaires on eating behaviour was used to collect quantitative and qualitative data. Data were collected via a combination of telephone interviews and online surveys.

Results: Of the 28 patients contacted, 13 (46%) were successfully recruited into the study. The results showed that most of the study participants did not exhibit abnormal eating behaviour. Additionally, the patients did not show an increased prevalence of being overweight at the time of data collection. A higher temporary tendency to be overweight was only observed when considering the overall weight trend. Dietary interventions placed a higher burden on family life in infancy (0-4 years) than at the time of the survey. Maintaining a safe fasting interval was the main reason for restrictions in family life.

Conclusion: This observational and exploratory sample showed no tendency towards abnormal eating behaviour associated with dietary management in MCADD.

Background: Food insecurity is a growing concern globally, particularly in conflict-affected settings. In these contexts, hospitalized patients face heightened risks of poor health outcomes. The present study aims to assess the risk of food insecurity among hospitalized patients in Lebanon and investigate its association with social determinants of health (SDH) amidst multiple crises.

Methods: A cross-sectional observational study was conducted from May to October 2021 on a random sample of adult hospitalized patients in five large hospitals across different districts inLebanon. A structured survey was used to collect socio-demographic characteristics, sources of health coverage, and medical history among study participants. In addition, survey included analysis of four indicators considered as integral part of SDH criteria: (1) area of residence and household size, (2) level of education, (3) employment status and type of employment, (4) healthcare access and coverage. Risk of food insecurity among praticipants was screened by a validated two-question tool, adapted from the US Department of Agriculture Household Food Security Survey. Associations between the SDH and risk of food insecurity were explored using logistic regression analysis using STATA V13.1.

Results: Among the 343 participants, the majority (79.5%) were identified as being at risk of food insecurity with 62.4% classified as experiencing mild food insecurity, 15% as moderate, and 2.1% living with severe food insecurity. Higher odds of food insecurity were observed among residents of of predominantly rural areas mainly in the North of Lebanon (OR = 6.59, CI [1.79; 24.32], p = 0.005) and Bekaa (OR = 2.55, CI [0.92; 7.05], p = 0.071) districts. Additionally, participants with higher levels of education, particularly those with high school degree or higher, had lower odds of food insecurity (p < 0.05). Employment status, household size, and healthcare coverage were not found to be significant predictors of food insecurity among hospitalized patients in the multiple logistic regression analysis in the study sample.

Conclusion: The study highlights the critical role of SDH, including educational level and geographical residence on experience of food insecurity among hospitalized patients. Screening for risk of food insecurity and associated determinants in health care settings are critical to design adequate programs and interventions to mitigate the risk of food and nutrition insecurity among vulnerable groups, particularly in conflict-affected settings.