Browsing by Author "Apprey, Charles"

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    Anemia Predicts Physical Fitness Among Adolescent Athletes in Ghana
    (Health Science Reports, 2024) Eli‐Cophie, Divine; Apprey, Charles; Annan, Reginald A.; 0000-0002-4071-5049
    Background: Anemia indicates low blood hemoglobin levels and has become a public health problem among adolescents in developing countries. The prevalence among adolescent athletes and its effect on physical fitness has not been studied in Ghana. The study aimed to assess the impact of anemia on physical fitness among adolescent athletes in Ghana. Methodology: The sample of 194 adolescent athletes was randomly recruited from competitive athletic groups, boxing, and football clubs in Greater Accra, Ashanti, and Volta regions of Ghana. Anthropometric parameters and Hemoglobin concentration were measured. Physical fitness was assessed using, right and left‐hand grip strength, reaction time, flexibility, and the Cooper‐12‐min run test, all following standard procedure. Results: The adolescent athletes of mean age (15.8 ± 2.5 yrs) and weight (54.0 ± 12.8 kg) were mostly of normal weight‐for‐age and height. The overall prevalence of anemia among the adolescent athletes was 14.3%. Anemia was however, more common among early adolescents (20.7%). The average hemoglobin level was lowest among the early adolescents (12.8 ± 1.1 g/dl), however, there was no association between anemia and the adolescent age group (X2 = 2.112 p = 0.348). Although the proportions of anemic males and females were similar (14.3%), the mean hemoglobin levels were significantly higher among males (13.6 ± 1.5 g/dl) than females (12.5 ± 1.2 g/dl). There was an association between hemoglobin and cardiorespiratory endurance (r = 0.324, p = 0.005), hand grip strength as well as relative handgrip strength (r = 0.379, p = 0.001). Hemoglobin significantly predicted 10.5% of the variation in cardiorespiratory endurance (R2 = 0.105, b = 0.623, p = 0.005) of the athletes. Conclusion: Hemoglobin levels could predict the cardiorespiratory endurance and muscular strength of adolescent athletes. Anemia is a public health problem among adolescent athletes and must be given the needed attention to make these athletes competitive and win laurels.
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    Dietary diversity and nutrient adequacy among women in Bosomtwe District, Ghana
    (Maternal & Child Nutrition, 2024) Apprey, Charles; Addae, Hammond Yaw; Boateng, Grace; Aduku, Linda Esi; Annan, Reginald A.; 0000-0002-4071-5049
    The sustainable development goals seek to end all forms of malnutrition of women of reproductive age (WRA) by 2030. As such, recent data on nutrient adequacy are needed to aid in tracking progress. However, data on specific dietary nutrient intakes includes only iron, folate, vitamin A, and vitamin B12 in Ghana. Therefore, women's dietary diversity score (W‐DDS) is often used as a proxy measure of nutrient adequacy. It is hypothesised that there is no association between W‐DDS and Nutrient Adequacy among WRA in peri‐urban Ghana. Hence, this research evaluated the associations between W‐DDS and nutrient adequacy ratio (NAR) and assessed the determinants of mean nutrient adequacy ratio (MAR) in the Bosomtwe District of Ghana. A community‐based cross‐sectional study was conducted, and data collected on anthropometry, food insecurity, socio‐demographic characteristics and dietary intake using the 24‐hour recall from 407 WRA. In all, 21 nutrients were assessed. The mean age, W‐DDS, and MAR were 29.0 ± 6.7 years, 5.3 ± 1.9, and 0.65 ± 0.19 respectively. The NAR were generally high for the macronutrients as compared to micronutrients and the nutrients with low NAR included vitamin C (0.27 ± 0.19), vitamin A (0.15 ± 0.23), vitamin B12 (0.54 ± 0.32), calcium (0.28 ± 0.20), zinc (0.52 ± 0.23) and iron (0.57 ± 0.28) ‐ signifying the WRA may be consuming monotonous carbohydrate‐based diet. The hierarchical multivariable linear regression found a significant association between W‐DDS and MAR after controlling for confounders (β = 0.404, p < 0.001). The determinants of MAR were ethnicity (β = 0.110, p = 0.006) and body mass index (β = 0.189, p < 0.001). This study supports the use of W‐DDS as a proxy indicator of nutrient adequacy. Strategies meant to address nutrient inadequacies should be adaptable to different ethnic groups and overweight‐reducing strategies should be incorporated into broader nutrition initiatives.
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    Dietary diversity and opportunistic infections among adults living with human immunodeficiency virus on antiretroviral therapy in Kumasi metropolis; a facility-based cross-sectional study
    (BMC Infectious Diseases, 2025) Apprey, Charles; Addae, Hammond Yaw; Osei, Monica; Danquah, Irene; Annan, Reginald A.; 0000-0002-4071-5049
    Background: Despite advances in antiretroviral therapy (ART), people living with human immunodeficiency virus (HIV)/ acquired immunodeficiency syndrome (AIDS) continue to face heightened susceptibility to opportunistic infections (OIs). Adequate nutrition remains an essential factor that positively influences disease progression and the occurrence of OIs. In Ghana, no study has evaluated the association between dietary diversity and OI occurrence among adults with HIV. This study aimed to evaluate the association between dietary diversity and the presence of OIs among HIV-positive adults receiving ART. Methods: A facility-based cross-sectional study was conducted among 291 HIV-positive adults receiving ART from February 2023 to April 2023 at Kumasi South Hospital, Ghana. The study participants were selected using a convenient sampling method. A pre-tested questionnaire and review of electronic health records were used to collect sociodemographic, nutritional and clinical data. Binary logistic regression analyses were conducted to identify variables significantly associated with the study outcome and hierarchical multivariable logistic regression was used to evaluate the association between dietary diversity and the occurrence of OIs while controlling for confounders at p-value<0.05. Results: The mean age and dietary diversity were 46.2±10.9 years and 4.0 (IQR: 3.0 to 6.0) food groups, respectively. Out of 291 respondents, 152 (52.2%) had inadequate dietary diversity and 39 (13.4%) had at least one OI. The respondents with inadequate dietary diversity were three times more likely to have an OI than their peers with adequate dietary diversity [AOR 3.03, (95% CI: 1.20 to 7.64), p=0.019]. Conclusion This study revealed that inadequate dietary diversity is a significant nutritional problem and dietary diversity was associated with the presence of OIs among PLWHA on ART at the study site. Hence, there is the need to enhance the intake of diversified diets based on locally available foods. This could decrease the occurrence of OIs and eventually reduce HIV-related morbidity/mortality.
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    Exclusive breastfeeding: an exploratory thematic analysis of the perspectives of breastfeeding mothers and significant others in the Tamale metropolis of Northern Ghana
    (BMC Nutrition, 2024) Tahiru, Rafiatu; Amoako, Mary; Apprey, Charles; 0000-0002-4071-5049
    Introduction: Exclusive breastfeeding is widely recognized as the optimal way to feed infants due to its numerous health benefits for both the child and the mother. Despite its advantages, Ghana is still far from attaining World Health Organization (WHO) recommended rates. This study is aimed at exploring the knowledge attitude and practices, where the practices hinged on facilitators, barriers, and sociocultural perspectives of breastfeeding mothers and significant others on exclusive breastfeeding. Methods: This study employed an ethnographic thematic analysis framed by the socioecological model (SEM). Thematic analysis was paired with focus group discussions (FGDs). The study participants were recruited purposively by employing a snowball sampling technique with the assistance of community health volunteers. Three (3) FGDs were formed, with 10 participants in each group, to gather perspectives from breastfeeding mothers and significant others (partners and grandmothers) in three communities with Community-based Health Planning and Services (CHPS) compounds within the Tamale metropolis. With an interview guide, all FGDs were audio-taped, transcribed verbatim, and translated from local dialects to English. The emerging themes were used in writing a narrative account, guided by the principles of thematic analysis. Results This study identified three thematic areas: knowledge of exclusive breastfeeding (EBF); attitudes toward EBF and practices of EBF (facilitators, barriers, and sociocultural practices). There was some knowledge disparity among lactating mothers despite the overall high knowledge and subpar attitudes of some mothers. The practice of exclusive breastfeeding was substandard. The major hindrances identified were cultural barriers propagated by partners/husbands and grandmothers; the belief that the weather here does not support EBF; and the need for spiritual herbs in infancy. Supportive healthcare providers helped increase the practice of exclusive breastfeeding. Some support also came from partners and husbands, and some mothers showed unique positive behaviors by exclusively breastfeeding. Conclusion::This study revealed that while exclusive breastfeeding education has been ongoing for decades, sociocultural norms still influence mothers to deviate from WHO recommendations. Public education is recommended to dispel misconceptions surrounding exclusive breastfeeding, develop a food galactagogue to help with breastmilk volumes and create a supportive environment that empowers mothers and families to make informed choices that optimize the health and well-being of both infants and mothers.
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    Food acquisition and consumption by NOVAfood classification and lived poverty index among rural and urban households in SouthAfrica and Ghana
    (Public Health Nutrition, 2024) Agyapong, Nana Ama Frimpomaa; Annan, Reginald A.; , Kroll, Florian; Apprey, Charles; Aduku, Linda Nana Esi; Aidoo, Robert; Swart, Elizabeth Catherina; 0000-0002-4071-5049
    Objective: This study aimed to determine differences in food consumption by the NOVA food categories in South Africa and Ghana and how they relate to poverty and food supply systems. Design: This study used a cross-sectional design to assess household food acquisition and lived poverty index. Setting: The study was conducted in Khayelitsha and Mount Frere, urban and rural communities in South Africa, respectively, and Ahodwo and Ejuratia, urban and rural communities in Ghana, respectively. Participant: An adult in charge of or knowledgeable about household food acquisition and consumption was selected to participate in the study. Results: A total of 1299 households participated in the study. Supermarkets were a prominent source of ultra-processed foods for households in South Africa, while informal outlets were an important source of ultra-processed foods in Ghana. Consumption of unprocessed foods was higher among South African households (58·2 %) than Ghanaian households (41·8 %). In South Africa, deprivation was associated with increased odds of infrequent consumption of both unprocessed foods (OR 3·431 P < 0·001) and ultra-processed foods (OR 2·656 P <0·001) compared with non-deprivation. In Ghana, no significant differences were observed between deprived households and non-deprived households in relation to the consumption of the NOVA food classes. Conclusion: Different food supply systems and poverty are associated with household acquisition of the different NOVA food classes. Policies should be geared towards formal shops in South Africa and informal shops in Ghana to reduce the consumption of key obesogenic foods.
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    Food label experiences among tertiary students in the Western North Region of Ghana
    (Journal of Science and Technology, 2023) Tandoh, M. A.; Turkson, R.; Apprey, Charles; 0000-0002-4071-5049
    Food labels are important tools for promoting healthy eating, preventing food borne diseases and food allergies. Examining consumers’ experiences with food labels helps to measure their impact in fulfilling these purposes. A survey was conducted among 193 students from three Training Colleges in the Western North Region of Ghana. A validated questionnaire was used to solicit information on demographics, nutrition knowledge exposure, food label use, factors and challenges that affect food label use. There were 53.9% males and 46.1% females, with the majority of them within the age of twenty and twenty-five years (86.1%). Most participants viewed food labels as very important information used in the choice of packaged foods (89.6%). Food label information, often read by users were the expiry dates (94.2%), name of the product (89.1%) and manufacturing dates (83.9%). With nutrition information, participants focused very often on proteins (69.9%), fats (62.2%), vitamins and minerals (63.2%). Factors that influenced food label use were nutrition knowledge (73.1%), health status (70.5%) and educational level (61.1%). Even though food label use was high among participants, they strongly agreed that small font size (39.9%), inability to interpret nutritional values (36.3%) and unfamiliar terminologies (35.8%) impeded maximum utilization of the information. In addition, 48.2% agreed that limited time for shopping also limited their use of food label information. The study, therefore, suggests that public education on food labels should be intensified and policies that will simplify food label information should be considered to enhance better understanding and consequently promote healthy food choices.
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    Gut Microbiome-Targeted Nutrition Interventions and Growth among Children in Low- and Middle-Income Countries: A Systematic Review and Meta-Analysis
    (Current Developments in Nutrition, 2024-03) Addae, Hammond Yaw; Apprey, Charles; Kwarteng, Alexander; 0000-0002-0174-6862; 0000-0002-4071-5049; 0000-0002-0893-2908
    Background: Childhood malnutrition is a public health challenge of much interest and concern globally. However, a perturbed gut microbiome (GM) may limit some nutrition interventions’ effects among healthy children with undernutrition. Objectives: This review aimed to evaluate the effects of GM-targeted nutrition interventions on growth outcomes among children (0–59 mo) using published studies in low- and middle-income countries. Methods: The methods were guided by the Cochrane methodology. The literature search was conducted to include articles published from inception to July 2023 in PubMed, Google Scholar, and Cochrane Databases. We identified and included 35 studies among 11,047 children. The analysis was conducted considering various growth parameters in the qualitative synthesis and weight gain (kg) in the meta-analysis. Results: In the qualitative synthesis, 55.6% of prebiotics, 66.7% of probiotics, 71.4% of synbiotics, and 28.6% of “microbiome complementary feed” studies had significant effects on growth outcomes. Also, prebiotics had more studies with significant effects among healthy children, whereas probiotics, synbiotics, and “microbiome complementary feeds” had more studies with significant effects among children with undernutrition. Nineteen studies were included in the meta-analyses, of which 7 (36.8%) measured GM outcomes. The meta-analysis showed that prebiotics exhibited heterogeneity but had significant effects on weight in the intervention as compared with the control (mean difference [MD]: 0.14 kg; 95% CI: 0.02, 0.25; I2 ¼ 63%, P ¼ 0.02; 4 studies, n ¼ 932). Probiotics had significant effects on weight in the intervention (MD: 0.15 kg; 95% CI: 0.06, 0.25; I2 ¼ 42%, P ¼ 0.05; 8 studies, n ¼ 2437) as compared to the control. However, synbiotics (MD: 0.26 kg; 95% CI: –0.04, 0.56; I2 ¼ 41%, P ¼ 0.17; 4 studies, n ¼ 1896] and “microbiome complementary feed” (MD: –0.03 kg; 95% CI: –0.18, 0.11; I2 ¼ 0%, P ¼ 0.60; 3 studies, n ¼ 733] had no significant effects on weight in the intervention as compared with control. Conclusions: Although probiotics and synbiotics may be effective at enhancing growth among children, the selection of interventions should be contingent upon health status
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    Nutritional intervention in children undergoing chemotherapy for cancer
    (2015-07-12) Apprey, Charles
    Burkitt‘s lymphoma (BL) and Wilm‘s tumour (WT) are the two most common childhood cancers. BL is a malignant tumour of the B cells of the lymphoid tissues that affects mainly children in Africa and WT is a malignant tumour that develops in the kidney from nephroblast. For most cancers, chemotherapy is the main form of treatment but each step of the cancer continuum from diagnosis to recovery poses nutritional challenges. Poor nutritional status predisposes an individual to disease and makes disease progression faster and recovery slower; nutritional decline among cancer sufferers also decreases the effectiveness of treatment and can slow recovery. The study aim was to investigate the impact of high protein-based supplement on nutritional status, and recovery among children undergoing treatment for Burkitt‘s lymphoma and Wilms tumour treatment at the Komfo Anokye Teaching Hospital (KATH), Ghana and also to determine the anti-proliferative effects of Isoflavanoids isolated from soyabean (SB) and soyamilk powder (SMP) on Burkitt‘s lymphoma (DG 75) and other cell lines. The study was in 4 parts. In the first part, there was assessment of nutrient composition of the soymilk powder (SMP) used as a supplement. The second part, investigated the nutritional status of children suffering from cancer compared with an age and sex-matched non-cancer controls using a cross-sectional study design. The third part was a non-blinded randomized controlled trial of 32 children suffering from BL and WT who received soymilk powder (SMP) supplement and 32 non-supplemented cancer children. The intervention group was provided 2-weekly rations of the supplement measured to provide 80% RDA for protein for age and sex and were followed for 6 months, taking measurements at the 0, 3 and 6-months follow-up. During the follow-up nutritional status, some clinical parameters, deaths and recovery were monitored. Weight, height, mid-upper arm iv circumference (MUAC) and triceps skinfolds (TSF) were measured and wasting, underweight and stunting levels determined using World Health Organization (WHO) standards. Biochemical/hematological parameters measured were zinc, reduced glutathione, prealbumin and Hb. In the last part of the study, Isoflavones were isolated from soybean (SB) and soymilk powder (SMP) and the anti-proliferative effect of these isoflavones on Burkitt‘s lymphoma (DG-75) and leukemia (CEM) cell lines and prostrate normal cell lines (PNT 2) were investigated. Proximate analysis on the SMP revealed a protein concentration of 49.62% and was also found to be safe for consumption after microbial assessments. A total of 96 children (64 with cancer and 32 non cancer group) below the age of 15 years were enrolled for the second part. Repeated measure anova was used to compare differences between groups and p-value less that 0.05 was significant. With the exception of height, the cancer children had significantly lower weight (18.7 versus 27.4 kg; p<0.0001), MUAC (14.1 cm versus 17.8 cm; p<0.0001), TSF (4.9 cm versus 6.1 cm; p=0.0332), muscle arm circumference (MAC) (12.4 versus 15.8 cm; p<0.0001) and body mass index (BMI) (14.6 kg/m2 versus 18.4 kg/m2; p<0.0001). The cancer group had higher level of malnutrition by all indicators: Low BMI-for-age = 50%, stunting = 47%, wasting =31% and underweight = 34% compared to non-cancer controls (low BMI for age=4%, stunting = 25%, wasting= 8% and underweight= 7%). Among the cancer children 44% showed physical signs of wasting, 16% were oedematous and 44% had the sclera of the eye pale. The cancer group also had significantly lower levels of glutathione (p<0.0001) and prealbumin (p< 0.0001) than their non-cancer counterparts. SMP intervention improved the various anthropometric, biochemical/ hematological indices when the intervention group was more than the non-intervention group with height, weight and zinc being the exceptions. The SMP v intervention reduced low BMI- for-age by 39.4% and wasting by 25.6%. Anaemia was reduced by 84.2% in the intervention group and only 11.7% in the non-intervention group. Also, the percentage of children who were deficient in reduced glutathione improved by 21.9% in the intervention group compared to the 20.5% in the non-intervention group. In terms of recovery, the SMP improved recovery by 31%. In the final part of this work, the extract of isoflavones gave a higher concentration of genistein in SMP (5.5× 10-3 mg/ml) compared to 5.86× 10-4 mg/ml found in soyabean (SB). The concentration of daidzein in SMP was also higher (6.247× 10-3 mg/ml) than that found in SB (3.92× 10-4 mg/ml). The growth inhibitory effect of genistein on leukemia (CEM) cell line was stronger (IC50 = 767.5 mg/ml) than daidzein (IC50 = 2542.3 mg/ml). For the DG 75, genistein had an IC50 of 298.6 mg/ml and daidzein, IC50> 2542.3 mg/ml. The IC50 for SMP on DG-75 was 193.92 μg/ml and that for CEM, IC50= 54.17 μg/ml. In terms of selectivity index (SI) the SMP was able to prevent the proliferation of CEM and DG-75 than SB. In conclusion, this study revealed a high prevalence of undernutrition among cancer children compared to their non-cancer control. Nutrition supplementation using SMP improved the nutritional status of children with cancer. This is attributed to the higher protein, caloric and mineral composition of the SMP given to the intervention group. Furthermore, the anti-proliferative effect of isoflavanoids on lymphoma cell line DG-75 also suggest some level of anticancer activity of SMP.
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    Pearl millet instant beverage powder enriched with baobab pulp to improve iron and anaemia status of adolescent girls in rural Ghana: a study protocol for a cluster randomised controlled trial
    (British Journal of Nutrition, 2024) Atosona, Ambrose; Larbie, Christopher; Apprey, Charles; Annan, Reginald A.; 0000-0002-4071-5049
    Iron (Fe) deficiency anaemia is a public health concern among adolescent girls worldwide. Food-to-food fortification may be a sustainable and effective solution to Fe deficiency anaemia. However, the effect of food-to-food fortification on Fe deficiency anaemia reduction is understudied particularly in Ghana. This study seeks to investigate the efficacy of baobab pulp-fortified pearl millet beverage powder in improving the Fe and anaemia status of adolescent girls in Ghana. A three-arm cluster randomised controlled trial design, which will involve 258 anaemic adolescent girls (86/arm) selected through multi-stage cluster sampling in Kumbungu District of Ghana, will be used. Participants in arm 1 will receive 350 ml of baobab pulp-fortified pearl millet beverage, containing 13 mgFe (96 % of average RDA), 18·8 mg vitamin C (30·4 % of average RDA) and 222·1 mg citric acid, while participants in arm 2 will receive similar volume of unfortified pearl millet beverage, once a day, five times a week, for six months. Participants in arm 3 will receive the routine weekly Fe (60 mg)-folate (400 μg) supplementation for six months. Serum ferritin, C-reactive protein and haemoglobin (Hb) of participants will be assessed at baseline and end-line. The primary outcomes will be serum ferritin and Hb concentrations. Secondary outcomes will be prevalence of Fe deficiency, Fe deficiency anaemia and BMI-for-age. One-way ANOVA and paired t test will be used to compare means of serum ferritin and Hb levels among and within groups, respectively. This study will provide novel concrete evidence on the efficacy of pearl millet-baobab pulp beverage powder in improving Fe and anaemia status of adolescents
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    Predictors of hypertension among diabetic patients in the Ejisu municipality of Ghana [version 1; peer review: awaiting peer review]
    (F1000Research, 2024) Brenyah, Florence; Apprey, Charles; Agbenorhevi, Jacob K.; Mills-Robertson, Felix C.; 0000-0002-4071-5049
    Introduction The co-existence of hypertension with diabetes mellitus among diabetic patients is a setback to public health. About 40-75% of diabetic patients present with hypertension. The co-existence of hypertension and diabetes can accelerate complications such as stroke, myocardial infarction, nephropathy, and mortality. Available data indicate the devastating effects of hypertension and diabetes on individuals, families, and the economy as catastrophic. Therefore, knowing the predictors of hypertension among diabetic patients would inform the lifestyle and management of the two conditions. Objective The study focused on predictors of hypertension among diabetic patients in the Ejisu Municipality of Ghana. Methods The study employed a quantitative approach with a sample size of 120. Data were collected on sociodemographic characteristics, family history, 24-hour dietary recall, blood pressure, fasting blood glucose, glycated haemoglobin, total lipid profile, and anthropometrics. Data were analyzed using SPSS version 27. Results Out of 120 respondents, 85% were females with 77.5% above 50 years of age. A majority (66.7%) had a family history of diabetes with 76.7% having hypertension as a comorbidity. Fasting blood glucose was found to be 8.519 times more likely to present with hypertension. Systolic blood pressure, carbohydrate, and sodium intakes were 6.1%, 2.9%, and 0.1% respectively. However, diabetic patients with high HbA1c were 97% less likely not to present with hypertension. Conclusion Hypertension was found to be the most common comorbidity among diabetic patients in Ghana. Glycaemic control, systolic blood pressure, and dietary factors specifically carbohydrate and sodium intake were significant predictors of hypertension among the study participants.
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    School Feeding Programmes and Physical Nutrition Outcomes of Primary School Children in Developing Countries
    (Journal of Food Science and Nutrition Research, 2022) Yussi, Mustapha Titi; Adocta, Vincent Awuah; Apprey, Charles; Annan, Reginald A.; Galseku, Prosper; 0000-0002-4071-5049
    Context: School feeding programmes have been widely implemented and particularly in developing countries with the aim to improve school enrolment and attendance especially of girls and to reduce short term hunger to improve children’s performance in school. Beyond the first 1000 days of the lives of children, school feeding programmes remain one of the critical interventions that have used schools as a platform to contribute to the ful¿lment of their nutritional needs though the evidence to this effect is little and mixed. Objective: This review focused on assessing the impact of school feeding programmes on reduction in underweight, thinness, and stunting among primary school children in developing countries. Data sources: Electronic searches were carried out in PUBMED, SCOPUS and Cochrane library. The WHO clinical trials registry as well as reference lists of relevant articles were also hand searched. Data Extraction: Data was extracted from included studies which have been published in the past 10 years (2010 - August 2021) from original research where the main intervention was the provision of school based meals. Data analysis: Meta-analysis was conducted to determine changes in height-for-age (HAZ), weight-for-age (WAZ) and BMI-for-age (BAZ) z scores. A random effects model was applied to determine the mean difference in all outcomes of interest which were evaluated as continuous variables. Results: Children aged 3-16 years were enrolled in the included studies and the number of participants ranged between 321 and 2,869 across studies. Of the included studies, the feeding intervention provided for a minimum of 30% RDA for the age group with the intervention lasting up to a maximum of 34 weeks. The impact of school feeding intervention on HAZ, BAZ and WAZ showed statistically non-significant (p>0.05) mean differences of 0.02 (95% CI, -0.06 to 0.10), 0.11 (95% CI, -0.01 to 0.23) and 0.06 (95% CI, -0.04 to 0.16) respectively. Conclusion: School feeding interventions have not shown any significant positive effect on the physical nutrition outcomes of primary school children. Short duration of intervention during the studies, poor compliance to feeding and substitution of school meals could have accounted for the weak effect sizes.
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    The influence of nutrition knowledge, attitude, practices, and dietary diversity on obesity among market women in the Cape Coast Metropolis, Ghana: A cross‐sectional study
    (Health Science Reports, 2023) Apprey, Charles; Mensah, Martina; Agyarko, Desmond; Klu, Yaa Asantewaa K.; Acquah, Samuel; 0000-0002-4071-5049
    Background and Aims: Obesity and overweight are major public health threat affecting many people globally. This study aimed to examine the role of nutrition knowledge (NK), attitude, practices, and dietary diversity (DD) on the prevalence of obesity among market women in Cape Coast, Ghana. Methods: This cross‐sectional study was conducted at Abura and Kotokuraba markets in the Cape Coast Metropolis of Ghana. Apparently healthy female traders (n = 402) aged ≥18 years were selected randomly from the markets. DD was assessed with dietary diversity score (DDS) using a 24h dietary recall method. NK, dietary practices, and attitudes were assessed using validated semistructured questionnaires. Body composition parameters were assessed using appropriate tools. Descriptive and binary logistic regression analysis were performed. Statistical significance was considered at p < 0.05. Results: The prevalence of overweight was 31.84% and obesity was 39.30%. Majority of respondents had poor DD as about 91% had DDS <5. About 75% of the market women had no knowledge in nutrition. About 57% eat thrice daily and 82% take supper from 7 p.m. Knowledge in nutrition was significantly associated with body fat (OR = 0.45, 95% CI = 0.26–0.78, p = 0.004), body mass index (OR = 0.40, 95% CI = 0.28–0.71, p = 0.001), and waist‐to‐hip ratio (OR = 0.32, 95% CI = 0.19–0.56, p < 0.001) Conclusion: The prevalence of obesity and overweight was high among the market women. Poor NK and poor DD may have influenced this. A campaign on better dietary practices and delivery of nutrition education may help to minimize the prevalence of obesity among market women.