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JOURNAL OF NUTRITION & DIETETICS : GENERAL INFORMATION

ABOUT THE JOURNAL

Journal of Nutrition and Dietetics (JND) is a peer reviewed refereed international Journal encompassing all the sub-discipline of Nutrition and Dietetics. Issued twice a year, ISSN 2415-5195. Each issue contains approximately six articles. The journal is published on behalf of Kenya Nutritionists and Dieticians Institute. JND is a publication that promotes national and international nutrition and dietetics specific and sensitive research.

The Journal publishes original research articles, short communications and review articles in the following areas:

  • Clinical nutrition and dietetics.
  • Food service therapy.
  • Community nutrition.
  • Public health nutrition.
  • Nutrition practice and legal issues.
  • Food science and nutrition.
  • Multidisciplinary research related to the above areas.

OBJECTIVES

  • To promotes publication of national and international nutrition and dietetics specific and sensitive research.
  • To research into and provide public education on nutrition and dietetics.

TARGET GROUP

The target audience is primarily nutrition and dietetics scientists, related medical scientists, training institutions and food industry. 

Article Processing Fee:

JND does not receive funding from any institution/government. Hence, the management of the Journal is solely financed by the handling fees received from authors. The manuscript handling fees are required to meet operations expenses including review process and printing of hard copies. Being a print journal authors are required to pay a manuscript handling fee of USD 50 (Ksh. 5200) for the processing of their articles. Authors shall receive one hard copy of a journal and five copies of their articles for free. A copy of the journal shall be charged at USD 40 and any extra copy ordered together shall cost USD 25.  However, there are no submission charges.

 

Authors are required to make payment only after their manuscripts have been accepted for publication.

 
Editorial statement

What is the rationale for the creation of the Journal of Nutrition and Dietetics?

Impact factor

To be provided later

Indexing and abstracting

To be provided later

For more information contact

 

Editor-in-Chief,

Dr. David Okeyo. MSc, PhD, MPH.

Tel. (+254) 02608882

Email: chiefeditor@kndi.institute

 

Editorial Secretary,

Linda C Sigilai,

+254702818055

Email: kndijournal@gmail.com

Dr. David Okeyo - Editor-In-Chief

JOURNAL OF NUTRITION & DIETETICS : EDITORIAL

Editor-in-chief

Dr. David O. Okeyo, PhD (MSc, MPH) - Kenya Nutritionists and Dieticians Institute.

 

Editors

Prof. Edward G. Karuri, PhD - University of Nairobi.

Prof. Anselimo Makokha, PhD - Jomo Kenyatta University of Science and Technology.

Dr. Gordon Nguka, PhD - Masinde Muliro University of Science and Technology.

 

Editorial Office

Ms Linda Sigilai  - Kenya Nutritionists and Dieticians Institute.

Ms. Ruth Akelola - Kenya Nutritionists and Dieticians Institute.

 

Reviewers

Apply to become a reviewer reviewer@kndi.institute.

 

Editorial office

For questions related to manuscript submission:

Journal of Nutrition and Dietetics

P.O. Box, 20436-00100,

Nairobi, Kenya

Tel. +254 (020) 260 8882

Email: kndijournal@kndi.institute

JOURNAL OF NUTRITION & DIETETICS : ISSUES

Current Issue

articles in the most current issue.

Click the links below to order any of the issue.

Volume 2 Issue 1, 2018

Volume 3 issue 1

 
List of Issues

issues and their respective articles in the journal.

Volume 3 issue 1
The Socio-economic and Demographic Determinants of Resistant Hypertension Compared to Conventional Hypertension among Type 2 Diabetes Patients Attending Kisii Teaching and Referral Hospital

Mary Mueni Mbithi1*, Gordon Nguka2, Tabitha Wanjau1,

1School of Health Sciences, Kisii University, P.O Box 408-40200, Kisii, Kenya

2School of Public Health, Biomedical Sciences and Technology,

Masinde Muliro University, Private Bag, Kakamega, Kenya

*Corresponding Author email: marycarman14@gmail.com

ABSTRACT: Diabetes and high blood pressure represent the most common comorbidities. Resistant hypertension is high blood pressure (blood pressure >140/90 mm Hg) despite therapy with at least three antihypertensive drugs; one being diuretic at tolerated doses, has been reported to be common among type 2 diabetes patients. This study determined the association of socio-economic and demographic determinants of resistant hypertension compared to conventional hypertension among type 2 diabetes patients attending Kisii teaching and referral hospital (KTRH). The descriptive study design was used and 96 adult study participants with type 2 diabetes were selected consecutively where 48 study participants recruited had conventional hypertension and the other 48 participants had resistant hypertension for the last one year. Descriptive analysis component was included in the socio-demographic components.  Inferential statistics took two forms; correlation coefficient statistics and Chi-square test and binary logistic regression. Pearson’s Chi-Square test analyzed categorical variables. Study results indicated age, gender, physical activity, and education level are significant at P=0.022, P=0.034, P=0.002, and P=0.020 values respectively. However, occupation and income levels were insignificant determinants of resistant hypertension compared to conventional hypertension among type 2 diabetes patients attending KTRH. The results expanded our understanding of risk factors of resistant hypertension among type 2 diabetics hence effective management of this condition. In conclusion, the study observed significant and insignificant determinants of resistant hypertension as shown by the p values above. This study recommends health education to increase knowledge and awareness of these key determinants of resistant hypertension compared to conventional hypertension among type 2 diabetes. 

Keywords: Resistant Hypertension, Conventional Hypertension, Type 2 diabetes.

Influence of Households’ Socio-Economic and Demographic Characteristics on Morbidity and Nutritional Status of Preschool Children in Ganze- Kilifi County, Kenya

Mungai Beatrice Okoth1, 2, Makokha Anselimo2, Kyallo Florence2,

Onyango Arnold2, Mutuku Francis1

1.Technical University of Mombasa

  1. Jomo Kenyatta University of Agriculture and Technology

ABSTRACT: Globally, socio economic and demographic status of households have been shown to influence the health of school children. However, knowledge of the impact of these factors on children’s health is scarce in Kilifi County.  This study evaluated the influence of households’ socio-economic and demographic characteristics on Preschool children’s morbidity and nutritional status in Ganze Kilifi County, Kenya. A total of 288 pre-school children (3-5 years) and their households were selected from ten Government schools five which had a school lunch programme (study group) and five without the programme (Control group) but in the same locality. Households’ socioeconomic and demographic data was collected by trained research assistants using pretested questionnaires. WHO Anthro programme was used to evaluate children’s nutritional status and SPSS version 24, and SAS version 9.4 statistical software for Data analysis. The threshold for statistical significance was set at p<0.05. Household heads with no formal education were 30% and the average income of the households was KES. 3000-5000 per month. Households’ average daily allocation to food was Kes.100-150. Children enrollment in preschool was 65% for boys and girls 35%.  Children who were sick two weeks, prior to the interview were 2 times more likely to be stunted [OR=2.20; 95%CI=1.25 - 3.85; P=0.006] and 2.5 times more likely to be underweight [OR=2.66; 95%CI=1.48 - 4.77; P=0.001] compared to children without sickness. This study found that socio economic and demographic factors influenced morbidity and nutritional status of the preschool children. The study showed that the long distance to health services, low education level and income contributed to increased ill health and morbidity resulting into stunted and underweight children. The study recommends that the relevant authorities should improve access to clean water and sanitation in addition to community health outreach services targeting the children. Also, the community should be supported and encouraged to engage in income generating activities for economic empowerment.

Key Words: households, morbidity, nutritional status, preschoolers, socio-economic status.

Determinants of moderate wasting in children living in an urban residence: A Case Study of Nairobi

 

Jeff Wamiti1, Wambui Kogi-Makau1, Sophia Ngala1 and Francis Ephraim Onyango2

 

  1. Department of Food Science, Nutrition and Technology, University of Nairobi.

2 Department of Paediatrics and Child Health, University of Nairobi.

Corresponding author: Jeff Wamiti, Telephone; +254724409655 Email: jwamiti72@gmail.com

ABSTRACT: In Nairobi County, 60 % of the population live under one US Dollar per day and occupy informal settlements which represents 6 % of the land area. Informal sector and casual labour are the urban poor’s main source of income which barely meet the household consumption needs. Children living in these urban slums thus experience both chronic and acute malnutrition being often wasted due to food insecurity. The study sought to generate information on the most significant factors associated with moderate wasting in children living within an urban residence. A cross sectional study of 144 moderately wasted children was conducted at Mbagathi District Hospital in Nairobi County between 8th May – 5th August 2017. A semi-structured questionnaire was used to collect household socioeconomic and child dietary intake data from child caregivers. Independent variables were correlated with energy intake in order to establish the strength and direction of correlation. The mean number of household members was 4.64 while the dependency ratio was 1.5 which was higher than that of Nairobi County (0.47). The mean frequency of meal consumption among study children was 5.3 ± 1.9 meals/day however the mean energy intake was 250.6 ±59.3 kcal/day representing 31.3 % of their energy requirement. Factors that were correlated to energy intake were; frequency of meal consumption (r=0.7; p=0.00) and the household dependency ratio (r=-0.4; p=0.03). Households with a high dependency ratio are likely to have a child with moderate wasting. The frequency of feeding for most children was adequate, however the meals lack adequate energy density which can lead to moderate wasting.

Key words: Energy intake, socioeconomic factors, frequency of meal consumption.

Body Mass Index and dietary diversity of kitchen workers using different types of cooking fuels in Morogoro Municipality, Tanzania

 

Mwanri AW1*, Mahembe A1 and Msuya, JJ1

1Department of Food Technology, Nutrition and Consumer Sciences, College of Agriculture, Sokoine University of Agriculture, P.O. Box 3006, Morogoro, Tanzania

*Corresponding author: akwmwanri@sua.ac.tz OR akwmwanri@hotmail.com

ABSTRACT: Vulnerability to indoor pollution depends on the individual’s nutritional status as well as the nature and duration of exposure. The aim of this study was to assess Body Mass Index (BMI) and dietary diversity among kitchen workers in Morogoro Municipality, Tanzania. A total of 360 randomly selected kitchen workers from hotels, institutions, fast food restaurants and street food vendors were studied in a cross-sectional study and their weight and height were measured using standard methods. BMI was calculated and categorized using World Health Organization criteria. Information on socio-demographic, respiratory symptom and type of fuel used was collected using a pretested questionnaire. Dietary diversity was assessed using FAO/FANTA guideline. Data analysis was done using SPSS version 20 and Microsoft excel version 10. Results indicate that, there were more female kitchen workers (65.3%) who were relatively younger with mean age of (28 ± 7.6) years compared to (32.6±7.4) years for males. About half of the kitchen workers were overweight (48%) or obese (14.7%). Males were more overweight (52%) and obese (21.6%) compared to 46% and 11% for females respectively. Prevalence of obesity was significantly higher among hotel workers (25%) compared to workers of other institutions, fast food restaurants, households and food vendors; however; there was no significant difference in BMI status with respect to type of fuel used and respiratory symptoms. About 68% consumed more than 4 food groups in a day preceding the survey. The most commonly consumed groups were cereals, fats/oils, and sugars. Vegetable consumption was also high reported by 75% of the respondents. Eggs, milk and fruits were the least consumed food groups reported by 3.2%, 13.5% and 38.1% of the respondents respectively. Overweight and obesity were common among kitchen workers, surprisingly more common among males than females. Other exposure variables were not associated with overweight and obesity. More research is needed to support the present results especially on kind of particulate matter that are produced from kitchen fumes.

 

Key words: Kitchen workers, fuel, BMI, Dietary diversity

Dietary Practices and Blood Glucose Levels among Adults with Type 2 Diabetes attending Meru Teaching and Referral Hospital, Meru County, Kenya

 

Mugambi Terry1, Peter Chege2, Eunice Njogu2 and David Okeyo

1

1Kenya Nutritionists and Dieticians Institute, Kenya

2Food, Nutrition and Dietetics Department, Kenyatta University, Kenya

*Corresponding author Email: mugambitrizah@gmail.com

ABSTRACT: Globally, due to lifestyle changes, type 2 diabetes is rampant causing a serious health concern and more so in developing countries. The disorder threatens to reach pandemic levels if actions are not taken and the situation is critical in Kenya, since diabetes prevalence is on the rise which threatens the health of general public and national economy. Unfortunately, little progress has been achieved in the management of diabetes regardless of numerous initiatives. This predisposes patients to complications and mortalities which can be averted. Dietary practices play a fundamental role in managing type 2 diabetes mellitus whereby it reduces blood sugar levels that help in both prevention and management of type 2 diabetes mellitus. Moreover, dietary practices help in weight loss that would otherwise lead to overweight and obesity which predisposes individuals to insulin resistance. The study, for that reason, sought to assess dietary practices and blood sugar level among adults (19-60 years) with type 2 diabetes attending Meru Teaching and Referral Hospital. A cross-sectional analytical study design was applied on a comprehensive sample of 157 type 2 diabetes mellitus adults attending the hospital. Data were collected using a semi-structured questionnaire, focus group discussion guides and key informant interviews. Glycated hemoglobin was used to test for the blood glucose levels while dietary diversity score, 24-hour dietary recall Questionnaire, food frequency questionnaire was used to determine dietary practices. Data obtained was coded, cleaned, entered in Ms-Excel and analyzed using Statistical Package for Social Sciences Software version 20. Noteworthy, 86.6% had high glycated hemoglobin with a mean of 9.7±2.64. In addition, energy intakes (1971 kilocalories) were below the recommended values in both males and females. Pearson correlation for carbohydrate was (P-value <0.014) which was significant among other selected nutrients (Table 6). Adhering to good dietary practices have positive influences on the blood glucose levels of participants. Therefore, there is need for informed and up to date facts and coordinated information by health care stakeholders to the diabetic adults to ensure they grasp the correct information.

Key words: Type 2 Diabetes Mellitus, Dietary Practices, Blood Glucose Level

Cancer Chemoprevention through Consumption of African Leafy Vegetables: A review

 

Caroline Muthike1*, Jasper Imungi1, and Wambui Kogi_ Makau1

  1. Department of Food Science, Nutrition and Technology, University of Nairobi-Kenya

*Corresponding Author Email: muthikecaroline@gmail.com, Tel:+254 0713 817 478

ABSTRACT: Globally, 18.1 million new cancer cases out of which 9.6 million deaths occurred due to cancer in the year 2018. Consumption of vegetables and adopting a healthy lifestyle has been shown to be the way to reduce the risk of preventable cancer. The mechanisms in which vegetables prevent cancer occurrence, progression and survival are areas that have limited information hence knowledge gaps. The objective of this review is, therefore, to establish if African leafy vegetable could have chemoprevention potential against various types of cancers.  The study selection was based on defined keywords (cancer chemoprevention and African leafy vegetables). A search was carried out on PubMed to retrieve all publications on cancer chemoprevention and African leafy vegetables. Only studies that met the search criteria were retrieved and the required data obtained. Data were synthesized by obtaining eight studies that met the criteria. The publications were analysed to establish whether African leafy vegetables could prevent cancer and the mechanisms of prevention. Amount or doses of the vegetable extracts used were also noted. The articles reviewed indicated that African leafy vegetables had a cytotoxic effect, or the vegetables contain anticarcinogenic effect in both human cancer cell lines and animal models. African leafy vegetables that had cytotoxic of anticarcinogenic effects were: Amaranthus, mustard, Ethiopian kale and Nauclea pobeguinii. Sweet potato leaves showed some compelling evidence of anti-cancer properties.

Keywords: Chemoprevention, Health, Nutrition, African leafy Vegetables, Human cancer cell lines, animal models

The Influence of Culture on Child Nutrition Status in Lurambi Sub-County, Kakamega County, Kenya

 

Purity W. Kamande1, Silvenus O. Konyole2

1Department of Health Promotion and Sport Science, Masinde Muliro University of Science and Technology

2Department of Nutritional Sciences, Masinde Muliro University of Science and Technology

Corresponding author: Purity W. Kamande Email: wambuikamande@gmail.com Tel.: +254728996946

ABSTRACT: Malnutrition is a significant health problem that has existed for the longest time possible in the various forms that it manifests in. In Kenya, it remains a major problem regardless of ways being availed to tackle this. The research was carried out to determine the relationship between culture and child nutrition in Kakamega County, Kenya with the focus being on Sheywe ward, Lurambi Sub-county. The target population was children under 5 years and their caregivers. The objectives for this study were; to determine the impact of aspects of culture on child nutrition, to establish the negative cultural practices that impact on nutrition and feeding practices of children, to find out the cultural interventions used to avert malnutrition in children and to investigate the mother’s sources of information with regard to infant and young child feeding. The study adopted the analytical cross-sectional study design. Sampling technique used was simple random sampling. A total of 59 households with children of age 0-60 months participated in the study. An interviewer-administered questionnaire was used to assess if breastfeeding was practiced exclusively, the type of complementary foods given to the infant, maternal nutritional knowledge and sources of nutritional knowledge. The study identified factors such as educational level(p=0.029) impacted on understanding of exclusive breastfeeding. Findings established that complimentary feeding started at an early age among a larger majority of the respondents. This study aimed to inform programmes targeting nutrition education among mothers and caregivers in the rural and urban setting.

Key words: malnutrition, culture, child, community, maternal

Additional Tactics and Strategies to Fight COVID-19: Integrated Approaches in Management

David Omondi Okeyo and Martin Kiome

Kenya Nutritionist and Dieticians Institute

Email: jandigwa@yahoo.co.uk

The authors took time to write this short communication to demonstrate quick response for the institute towards pushing a workable policy agenda during the fight against Covid-19 pandemic. The write up was guided by the biblical mindset and divine interventions that would provide a national and by extension global solutions to fight against COVID-19 pandemic.

First and foremost, the team congratulated the nation of Kenya and particularly his Excellency the President of the Republic of Kenya, Honorable Uhuru Muigai Kenyatta for the mechanisms he has put in place so far and giving this matter the seriousness it deserves. The good thing was that our president declared a national prayer day which meant that he seriously recognized divine intervention towards this plague (in the spiritual world) which now become a pandemic. It was therefore realized that biblical plagues were not new even though they are real. Plagues have been documented in the biblical history of mankind and none of the documented cases wiped the entire human generation. They are meant to alert people to be sensitive of supernatural world beyond human limitations. 

Having said that, we applauded medical public health strategies so far used in this fight against covet namely;

  1. Quarantine methods
  2. Targeted and random testing for the disease
  3. Social distancing
  4. Isolation of patients for monitoring and treatment.
  5. National curfew.
  6. Cessation of movement in some major cities and towns.
  7. Hand washing with clean water and soap.
  8. Frequent use of alcohol-based sanitizers among others

All these methods were scientific and practical in curtailing the spread of the virus. However, the methods had not dealt with the social problems that were important and could be very lethal to human generation. This include;

  1. Fear
  2. Hunger
  3. Depression, Anxiety and Stress (DAS)

In the subsequent sections, the communication explains the context of the above three in setting up additional epidemiological interventions. 

The above social public health problems are more lethal than the virus which seems to be at the center

of in many nations. To avoid doubt, it is critical to take note of the following;

  1. Fear is a mental health problem which attacks humanity and totally puts them off balance to appropriately think. It has no respect for those with big titles, medics and even health professionals at large. But it has respect for the men with divine wisdom and true men of faith in God. Faith drives fear away from men and make them begin to think with sobriety in the area of expertise.
  2. Hunger is both a physical and a mental health problem and brings emotional instability to the point of zero thinking. Hunger may lead to anxiety, stress and depression. It is slow in effect but lethal for the generation than a virus or bullet when added to infection and may result to multiple health problems.
  3. Anxiety, stress and depression are the results of fear and hunger which have potential to cause massive and multiple morbidity cases as well as deaths of victims. It is actually a bigger problem than what we think.

In view of the above, the government therefore needed to step back and think ahead of the physical disease effects and deal with them.

We proposed the following additional approaches as follows:

Spiritually

It was time for leaders to open up places of worship and allowed men of faith to preach the gospel. It was further explained that places of worship are where God deals with the aspect of fear and allows men and women to think properly for expertized interventions to work.

Ideally places of worship are the best conduits to set up advocacy and health education strategies. Now that majority (90%) of cases of Covid-19 in Kenya are mild, and we have closed our borders, concentrated education and advocacy can be channeled through our place of worship which means public health interventions can be properly implemented within and through the place of worship. (Pamphlets, leaflets and demonstrations can be shared to relay information on public health interventions against spread of COVID-19).

Our God answers prayers of the elect and men of faith. This hidden force from the supernatural can stop the spread of the virus by taking away fear and building confidence in people to be personal agents of behavior change. It is evidence that market places are more risk settings than place of worship. (For example, from a Christian perspective, the bible has demonstrated that spiritual food is as good as physical food). 

{Remember plagues visited Pharaoh and his congregates but none of such had effect among the Jews. These spiritual Jews are still alive in our country as we know we are prayerful nations. Let us not take this opportunity to condemn spirituality, it is a higher risk for those who don’t embrace it. Ref: The Bible

Proposed Practical Strategies

  1. Place of worship should be allowed to host a certain number of attendees per session to ensure that members maintain a 1.5 metre social distance from each other.
  2. Once a place of worship has met the threshold of the number of attendees, the rest can either go back home or wait to attend second, third or fourth summons or stream live from the comfort of their homes. At least some people must be in places of worship.
  3. Use of hand sanitizers should be made mandatory for all the members at the entry points.
  4. All the attendees should wear face masks and their temperatures taken at the points of entry.
  5. Each church should have a one-hour slot for public health education with a focus on the World Health Organization guidelines and measures put in place by Ministry of Health, Kenya.
  6. People who have no personal cars should be advised to attend church services in temples/auditoriums within the nearest proximities of their dwelling places.
  7. Those with personal automobiles can use but advised to maintain 1-meter distance if they carry any passengers.
  8. Disinfectant spray booths can be installed in some large place of worship.

Healthy Eating and Exercise

This approach was also identified to be appropriate for wellbeing. We wanted to empathize the fact that diet and exercise plays a key role in managing injuries caused by infections and particularly those that exhibit symptoms that include inflammation, fever and mucus formation. It was also important to take note that food industry outlets especially supermarkets should be marked as high-risk carriers of unhealthy food commodities and potential risk for food infections and poisoning.

Proposed Practical Strategies

  1. We need to engage more nutritionists/dieticians by employing them across counties to educate the public on healthy food choices and healthy dietary habits that will deal with medical stress related to inflammations, hence the need to increase protein and energy requirements. Such additional nutrients due to stress factors need to be computed by experts.
  2. We should remember that social stress and anxiety also induces hormonal imbalance that increases demand from a diversified diet. Nutritionists and Dieticians are better placed to educate individuals and the public on this line especially at primary levels of healthcare; households and community health units. Worth noting, critical nutritional therapy is need at the intensive care units (Annex 1).
  3. Moderate exercise has a tendency of boosting immunity which naturally fights and prevents damages caused by any disease.
  4. We have observed that preservatives are being overused to increase shelf-life of perishable food products in super and hypermarkets. Inspection of such foods and public education would be critical if nutritionists and public health officers are involved to educate the public on these matters.

With the two approaches, we hoped that the matters raised would be put into consideration in the new strategies and policy decisions and guiding principles on the fight against the spread of virus while ensuring that more social related injuries were avoided. Along with this we also harmonized critical guidelines as custodians of the professional knowledge in nutrition/dietetics. (Annex 1).

The communications highlighted the fact that government should not be quick in putting up rules and regulations anchored on existing laws at this particular point in time. This would be a knee-jerk reaction. There was need to implement these laws effectively when there is no crisis. It was noted that at the time CAP 242 (Public Health Act) was developed sobriety prevailed. However, due to Covid-19 crisis new rules were being developed in a harry through fire-fighting. The communication also emphasized on the need to support health workers and frontline team with resources while raising an important question on actions already taken by government to fund artists. The big question was “why waste 100m on artists when we have health workers who risk their lives to attend directly to patients?” Finally, the communication had one lesson that governments should always plan to set up infrastructure and systems before any pandemic occurs.

Annex 1: Nutrition management of COVID-19

Etiology

COVID -19 is a serious respiratory viral infection caused by a novel coronavirus recently named SARS-COV2.  The outbreak started in Wuhan City, Hubei Province in mainland China and spread globally, infecting millions of people who have tested positive, Kenya not left out. SARS-COV-2 is acute respiratory disease which is spread from person to person through the coughing or sneezing of infected people (droplet infection) or by touching something with SARS-COV-2 viruses on it and then touching their mouth, nose, or eyes (contact transmission).

Symptoms

Symptoms of COVID-19 include;

  • Fever or difficulty breathing.

In addition, illness may be accompanied by other symptoms including;

  • Headache, tiredness, runny or stuffy nose, chills, body aches, diarrhea, and vomiting.

Like seasonal flu, COVID-19 in humans can vary in severity from mild to severe.

Guiding Principles for SARS-CoV2 Management

Like all interventions related to the care of the patient with COVID-19, the delivery of nutrition in critically ill patients should take into consideration the following principles: 

  1. “Cluster care,” meaning all attempts are made to bundle care to limit exposure.
  2. Adhere to Centers for Disease Control (CDC) recommendations to minimize aerosol/droplet exposure with an emphasis on hand hygiene and utilization of personal protective equipment (PPE) to protect healthcare providers and limit spread of disease.
  3. Preserve use of personal protective equipment (PPE) by limiting the number of staff providing care and optimizing other PPE preserving strategies.   

Therapeutic Management

One of the anticipated outcomes of the government guidelines on prevention of complications is to reduce incidence of stress ulcers and gastrointestinal bleeding. When dealing with Covid-19 patients;

  1. Assess and screen for risk of malnutrition. With limited PPEs, dieticians can rely on other health care workers for collection on physical information about the patient. They can also rely on their relatives. Collaboration will be key as the dietician aims to minimize exposure. It will be important for the dietitian to document how the information was collected.
  2. Carry out a diagnosis considering the co-morbidities.

It is recommended that nutrition information should be shared by qualified nutritionists and dieticians.

 

 

 

Nutrition Management

  1. Energy

It is recommended at 25 kcals/kg bwt increasing to 30 kcals/kg bwt for polymorbid patients or those with co-morbidites.

  1. Protein

A recommendation of 1g/kg bwt. For polymorbid patients this should increase to 1.2 – 1.3g/kg bwt to prevent loss of body weight and complications. Consider protein supplements in patients who are unable to meet protein targets due to significant contribution of non-nutritional calories. 

  1. Vitamins and Minerals

There is little evidence for vitamins and mineral supplementation. Vitamins A, C, D, B6 and minerals iron, selenium and zinc can be supplemented for those who are deficient.

  1. Fluid intake

Ensure intake of adequate fluids; at least two liters of water per day or
more if there is fever.

  1. Physical activity

For quarantined patients, it is important that they continue to engage in exercises for muscle strength.

For polymorbid patients, 400 kcal and 30g protein can be offered as nutrition support.

When do you initiate enteral or parenteral nutrition?

Initiating early enteral nutrition (EN) within 24-36 hours of admission to the ICU or within 12 hours of intubation and placement on mechanical ventilation should be the goal. Enteral nutrition should be initiated early for patients with co-morbidities and poly-morbid. Naso-gastric tube feeding can be initiated for enteral feeding with naso-jejunal being the alternative where NGT will not work.

Early PN should be initiated as soon as possible in the high-risk patient for whom early gastric EN is not feasible. Parenteral nutrition should only be initiated where the enteral nutrition cannot fully meet the patient’s daily requirements. This can be done through the central route or peripherally. For patients on TPN and in ICU they may have ICU acquired weakness characterized by catabolism. This is common in the old, frail and co-morbid patients. To mitigate this, increase protein intake and physical activity during the rehabilitation phase.

EN is preferred to parenteral nutrition (PN). Continuous rather than bolus EN is strongly recommended, this is supported by both the ESPEN and SCCM/ASPEN guidelines.

Volume 2 issue 1 2018      CLICK TO ORDER ISSUE

Spatial  distribution and predictors of vitamin A deficiency among children 6-23 months in Bungoma and Busia Counties, Kenya.  CLICK TO ORDER ARTICLE

Mary  Anyango et al

ABSTRACT: The study determined the prevalence and geospatial distribution of vitamin A deficiency among children aged 6-23 months in Busia and Bungoma counties. Analysis of spatial patterns using spatial indices and geographical visualizations of the presence and absence of significant high and low values of VAD was done. ArcGIS and GeoDa 1.6 were used for spatial analysis. A null hypothesis of spatial randomness was tested at a level of significance α=0.005 against the thought of Spatial Autocorrelation (SA). It was rejected giving a strong evidence of significant spatial patterns of VAD distribution in Bungoma and Busia. Local Indicators of Spatial Association were used to assess levels of local clustering. Regression analysis was conducted to model the most significant prediction equation for a set of 12 covariates. Exploratory Spatial Data Analysis was conducted followed by Ordinary Least Squares Regression (OLSR) on the predictor variables. Dependent variable was VAD while spatial and demographic variables were the independent variables. The results of OLSR were scrutinized by a set test diagnostic for the existence of spatial dependence (Lagrange Multiplier diagnostics). Analysis of Moran’s Index in Bungoma and Busia revealed heavy clustering of High-High (MI≥0.9). Lower parts of Bungoma and Busia showed heavy clustering of Low-Low values of VAD (MI≥0.9). Spatial error model yielded varying levels of coefficients with diverse spatial and non-spatial independent variables at α≤0.005 with a sensitivity of 999 permutations and λ=0.381. OLSR identified length of crop growing period, distance to health facilities and towns as the most significant spatial predictors of VAD.

 Key Words: VAD, Spatial distribution, Predictors

Positive deviant intervention prevents acute malnutrition in younger siblings of malnourished children Migori County, Kenya. CLICK TO ORDER ARTICLE

Calvince Otieno et al

ABSTRACT: Positive Deviance (PD) Hearth program is designed to reverse Moderate Acute Malnutrition (MAM) and prevent Severe Acute Malnutrition (SAM) in children below five years. The aim of the present study was to establish the degree to which PD Hearth prevents malnutrition among the younger siblings of children in the program and to identify the role of the PD Hearth program on improving local capacity and community participation and empowerment on nutrition interventions. PD Hearth program was designed in Migori County to reverse MAM and prevent SAM in undernourished children. Younger siblings of 60 children in the program were identified through single stage cluster sampling to evaluate the nutrition outcome six (6) months after the Hearth sessions. A pipeline quasi-experimental design and mixed methods were used to collect data and perform statistical analyses. Anthropometric measurements (height and weight) for the younger siblings of the children in the program were taken; chiefs and the CHWs were also interviewed using a pretest questionnaire. Younger siblings aged 0-6 months and 6-12 months had high nutrition indicators (above -1 score) for mean Weight-for-Height (WAZ), Height-for-Age (HAZ) and Weight-for-Height (WHZ). Also, siblings in the age categories, 12-24 had high Z-scores (greater than -1 score) in WHZ and WAZ but not HAZ (-2.14±0.04). The PD Hearth program had positive influence on the home and health care practices by mothers and health workers respectively. The caregivers also noted that involvement of the local leaders contributed to the success of the PD Hearth program.

Key words: Positive, deviance, Hearth, program, malnutrition

Household food security and nutritional status of HIV  Zero-positive patients in Longisa County Hospital, Kenya CLICK TO ORDER ARTICLE

Kenneth Kipngeno Tonui et al

ABSTRACT: Globally a total of 842 million people was food insecure between 2011 and 2013. The prevalence of food insecurity in Africa is high whereby close to 25% of Africa’s population is food insecure More than 10 million Kenyans are chronically food insecure and 1.6 million have HIV. Food insecurity remains a crucial problem in poor households, and its implications worsen in disease states including Human Immuno-deficiency Virus and Acquired Immune Deficiency Syndrome. The purpose of this study was to assess the household food security and the nutritional status of HIV sero-positive patients attending Comprehensive Care Clinic at Longisa County Hospital, Bomet County. The study used a cross-sectional study design on a sample size of 210 HIV sero-positive patients. A questionnaire was used to collect data on socio-demographic and socio-economic factors, anthropometric measurements, and food security status. Statistical analysis was done using Pearson-moment correlation, Chi-square, Independent sample t-test and one-way ANOVA. Results showed that 61.6% were females, household food insecurity prevalence was 17.7% About 23.7% of the respondent’s households had severe household hunger. Mean Household Hunger Scale score (HHS) was 1.56±0.061 indicating that most of the respondent’s households experienced moderate household hunger. 7.6% of the respondents were severely undernourished, and 15.2% were moderately undernourished. There was a significant relationship between nutritional status measured by BMI and household food security status at p=0.001. Household food security status measured by HHS and nutritional status had a significant association at p=0.001. Household food security status is a core determinant of the nutritional status of HIV sero-positive clients. Such information provides an ample platform for optimizing ART, enhancing rehabilitation, and adherence to treatment.

 Key words: Household food security, nutritional status, HIV sero-positive, dietary intake, malnutrition

Effect of nutrition education among fathers on exclusive breastfeeding of infants in Kisumu, Kenya CLICK TO ORDER ARTICLE

Lynette Aoko Dinga-Owiti et al

ABSTRACT: Breastfeeding is essential for infants providing them the much-needed nutrients for a health start. The World Health Organization recommends exclusive breastfeeding for the first six months of the infant’s life. The objective of this study was to assess the influence of nutritional education among fathers on exclusive breastfeeding practices for infants aged 0-6 months in Kisumu County, Kenya. An interventional study was conducted. The study setting was Kisumu East Sub County, Kenya. A total of 290 father-mother pairs were recruited into the study. Recruitment took place at Kisumu County hospital when the mothers were at 23-27 weeks gestational age. Pairs were randomized into either intervention or control group with 145 pairs per group.  Pairs in the intervention group received nutrition education on breastfeeding (exclusive breastfeeding and male involvement), while those in the control group did not receive any intervention during the one-year research period. Quantitative data on exclusive breastfeeding practice, maternal and paternal knowledge and support towards breastfeeding were collected using an interviewer administered pretested questionnaire, while qualitative data were collected through 4 focus group discussions in both intervention and control groups. The proportion of infants fed only mother’s milk at 6 months was significantly higher (77.7 %) in the intervention group than in the control group (45.1%, p<0.001). Fathers in the intervention group who had been exposed to nutrition education on breastfeeding and were knowledgeable on exclusive breastfeeding were twice more likely to exclusively breastfeed. Nutrition education to fathers on breastfeeding impacts positively on breastfeeding rates.

Key words: Nutrition Education, Father, Exclusive breastfeeding, Kenya.

Cancer  screening in association with consumption of leafy vegetables among a peri urban community of Nairobi  metropolis, Kenya. CLICK TO ORDER ARTICLE

Caroline Wakuthie Muthike et al

ABSTRACT: Cancer is an increasing health burden in the developing world. Diet and early cancer screening have been shown to be among the few measures that could either prevent or enable early detection hence higher chances of cure. Consumption of at least five servings of vegetables per day has been recommended in order to combat cancer and other non-communicable diseases. The objective of this study was to determine the consumption of green leafy vegetables and cancer screening. This study was cross-sectional in design which used a structured questionnaire to get quantitative information. Random sampling was used to get 439 households which participated through one respondent. The method used was interviewer administered questionnaire. The questionnaire included a Food Frequency Questionnaire (FFQ) over a week’s period and a demographics and economics questionnaire. Data was computed using the SPPS V. 16 software. Association was done using chi-square analysis individuals were interviewed on cancer screening. Significance level was at 95% or a P=0.05.The prevalence of cancer in the area was at 4%. More females (23%) than males (14%) went for cancer screening. There was a significant association between gender and cancer screening (χ28.034, df=1, P=0.005). There was also a significant association between occupation and cancer screening (χ228.158, df =6, P=0.000). The most daily consumed leafy vegetables were kales (18.72%), spinach (16.44%) and cabbages (5.71%). Consumption frequency of vegetables that were associated with cancer screening include: broccoli (P=0.00,Cl(0.000-0.001), kales(P=0.01,Cl(0.009-0.015), mushroom P=0.02,Cl(0.014-0.021), Spinach P=0.00,Cl(0.001-0.003) and pumpkin P=0.02Cl(0.019-0.027).The demographics associated with cancer screening were found to be gender and occupation. The vegetable consumption frequency that was associated with cancer screening includes: broccoli, kales, mushroom, spinach and pumpkin leaves.

 Keywords: Cancer screening, Cancer, Leafy green vegetables, Consumption frequency

Volume 1 issue 1 2017    CLICK TO ORDER ISSUE

Enhancing universal health coverage  through  nutrition and dietetics internship, CPD programme and research.  CLICK TO ORDER ARTICLE

David Omondi Okeyo and Julia Ojiambo

Dietary  knowledge as a determinant  of the dietary practices  and nutrition status  of amateurs male strength – athletes. CLICK TO ORDER ARTICLE

Jeff Wamiti  Muthui and  Edward  Gichohi Karuri

Prevalence and contributing  factors of malnutrition among children aged  6 to 24 months attending well-baby clinic at Mbagathi  District Hospital, Nairobi.

Self perceived body  weight status  among healthcare  workers in Kisumu, Kenya.  CLICK TO ORDER ARTICLE

Zakari M. Ondicho, David Omondi Okeyo, Christine Agatha Onyango

Perceived knowledge and attitudes towards African indigenous vegetables among high school students  in Kakamega county, Kenya. CLICK TO ORDER ARTICLE

Sigilai Linda,  David Omondi Okeyo, Asenath  Sigot, Emil Gevorgyan.

Household production  and consumption frequency of mursik among 1-5  years old children in Kapsabet location, Uasin Gishu county, Kenya. ORDER ARTICLE

Erick Kirui and Gordon Nguka

Articles in Press

 articles that have been accepted but not yet available in the current issue.

JOURNAL OF NUTRITION & DIETETICS : SUBMISSION

a. Submit a manuscript

Submit manuscripts as e-mail attachment to the Editorial Office at: kndijournal@kndi.institute. After submission you will receive an acknowledgement email with an assigned manuscript number.

Electronic submission of manuscripts Efforts are being made to facilitate this form of submission.

b. Author guidelines

The Journal of Nutrition and Dietetics (JND) (ISSN 2415-5195) is PRINT journal that provides rapid publication bi-annually of scientific articles in all subject areas of the subject of Nutrition and Dietetics. JND welcomes the submission of manuscripts that meet the general criteria of significance and scientific excellence.

 

Language: All manuscripts should be written in British English.       

Article length: The number of words should be <2,500 for short communication, 4000-6000 for original articles and 6000-8,000 for review articles. Tables and figure should be kept to a minimum. Both figures and tables should not exceed five.

 

The Title Page: Should contain a brief title that (Max. 20 words) describes the contents of the paper. The Title Page should include the authors’ full names and affiliations, the name of the corresponding first author along with e-mail and phone number.

 

The Abstract: Should be informative and completely self-explanatory, briefly present the topic, state the scope of the experiments or study other designs, indicate significant data, and pointing out major findings and conclusions. The abstract should be 250 words in length. Standard nomenclature should be used and abbreviations should be avoided. No literature should be cited. All abstracts should be detailed and follow the sequence background, objective, results, and conclusion continuous pros and one paragraphs.

 

Keywords Following the abstract, about 5 key words that will provide indexing references should be listed.

 

The Introduction: Should provide a clear background statement of the problem, supported by relevant literature on the subject highlighting gaps in knowledge and justification of the study. It should be understandable to colleagues from a broad range of scientific disciplines.

 

Materials and Methods: Should be complete enough to allow experiments and other study designs to be reproduced. However, only truly new procedures should be described in detail; previously published procedures should be properly cited, and important modifications of published procedures should be mentioned briefly. Capitalize trade names and include the manufacturer’s name and address. Subheadings should be used. Methods in general use need not be described in detail.

Results: Should be presented with clarity and precision. The results should be written in the past tense when describing findings in the author(s)’s study designs. Previously published findings should be written in the present tense. Results should be explained, but largely without referring to the literature.

 

Discussion: Speculation, critique and detailed interpretation of data should not be included in the results but should be put into the discussion section. The Discussion should interpret the findings in view of the results obtained in current and in past studies on this topic. Discussion section can include subheadings, and when appropriate, both sections can be combined.

 

Conclusion: The conclusion should include the most important findings of the study based on the set objectives and research questions/hypothesis, the author’s own findings, possible solutions to the problem, recommendations for further research, etc.

 

The Acknowledgments: People, grants, funds, etc. acknowledgements should be brief and should appear at the end of the paper just before references.

 

Conflict of interest Authors are responsible for disclosing any conflicts of interest that might bias the interpretation of results.

 

References: All references should use the Vancouver style of references. Articles should have a 15-40 reference, unless approved by the Editor.

Sample References

  1. O'Campo P, Dunn JR, editors. Rethinking social epidemiology: towards a science of change. Dordrecht: Springer; 2012. 348 p.
  2. Schiraldi GR. Post-traumatic stress disorder sourcebook: a guide to healing, recovery, and growth [Internet]. New York: McGraw-Hill; 2000 [cited 2006 Nov 6]. 446 p. Available from: http://books.mcgraw-hill.com/getbook.php?isbn=0071393722&template=#toc DOI: 10.1036/0737302658
  3. Halpen-Felsher BL, Morrell HE. Preventing and reducing tobacco use. In: Berlan ED, Bravender T, editors. Adolescent medicine today: a guide to caring for the adolescent patient [Internet]. Singapore: World Scientific Publishing Co.; 2012 [cited 2012 Nov 3]. Chapter 18. Available from: http://www.worldscientific.com/doi/pdf/​1142/9789814324496_0018
  4. Stockhausen L, Turale S. An explorative study of Australian nursing scholars and contemporary scholarship. J Nurs Scholarsh [Internet]. 2011 Mar [cited 2013 Feb 19];43(1):89-96. Available from: http://search.proquest.com.ezproxy.lib.monash.edu.au/docview/858241255?accountid=12528
  5. Kanneganti P, Harris JD, Brophy RH, Carey JL, Lattermann C, Flanigan DC. The effect of smoking on ligament and cartilage surgery in the knee: a systematic review. Am J Sports Med [Internet]. 2012 Dec [cited 2013 Feb 19];40(12):2872-8. Available from: http://ajs.sagepub.com/content/40/12/2872 DOI: 10.1177/0363546512458223
  6. Subbarao M. Tough cases in carotid stenting [DVD]. Woodbury (CT): Cine-Med, Inc.; 2003. 1 DVD: sound, color, 4 3/4 in.
  7. Stem cells in the brain [television broadcast]. Catalyst. Sydney: ABC; 2009 Jun 25.

Tables: Should be kept to a minimum and be designed to be as simple as possible. Tables are to be typed one-spaced throughout, including headings and footnotes. Tables should be prepared in Microsoft Word. Each table should be included after references on a separate page. They should be numbered consecutively in Arabic numerals and supplied with a heading (and a legend where necessary). Tables should be self-explanatory without reference to the text. The details of the methods used in the study should preferably be described in the legend instead of in the text. The same data should not be presented in both table and graph forms or repeated in the text.

Figures should be kept to a minimum. Each should be included after the tables, each on its own page. Graphics should be prepared using applications capable of generating high resolution GIF, TIFF, JPEG or PowerPoint before pasting in the Microsoft Word manuscript file.  Use Arabic numerals to designate figures and upper-case letters for their parts (Fig 1). Begin each legend with a title and include sufficient description so that the figure is understandable without reading the text of the manuscript. Information given in legends should not be repeated in the text.

c. Article Processing Fee

JND is a self-supporting organization and does not receive funding from any institution/government. Hence, the management of the Journal is solely financed by the handling fees received from authors. The manuscript handling fees are required to meet operations expenses such as employees’ salaries, internet services, webhosting, application development and support, electricity etc. Being an Open Access Journal, JND does not receive payment for subscription, as the journal is freely accessible over the internet. Authors are required to pay a manuscript-handling fee of USD 70 for the processing of their articles. Authors are required to make payment only after their manuscripts have been accepted for publication.

d. Peer Review Process

JND operates a single-blind peer-review system, where the reviewers are aware of the names and affiliations of the authors, but the reviewer reports provided to authors are anonymous. Publication of research articles by JND is dependent primarily on their scientific validity and coherence as judged by our external expert editors and/or peer reviewers. They will also assess whether the writing is comprehensible and whether the work represents a useful contribution to the field of Nutrition and Dietetics.

Submitted manuscripts will generally be reviewed by two to three experts who will be asked to evaluate whether the manuscript is scientifically sound and coherent, whether it duplicates already published work, and whether or not the manuscript is sufficiently clear for publication. Reviewers will also be asked to indicate how interesting and significant the research is. Decisions will be made as rapidly as possible, and the journal strives to return reviewers comments to authors within 8 weeks. The Editors will reach a decision based on these reports and, where necessary, they will consult with members of the Editorial Board.

 

CLICK HERE TO SUBMIT AN ARTICLE

CLICK HERE TO DOWNLOAD THE KNDI JOURNAL AUTHOR'S GUIDELINES

 

For more information contact

Editor-in-Chief,

Dr. David Okeyo. MSc, PhD, MPH.

Tel. (+254) 02608882

Email: chiefeditor@kndi.institute

 

Editorial Secretary,

Linda C Sigilai,

+254702818055

Email: kndijournal@gmail.com

JOURNAL OF NUTRITION & DIETETICS : SUBSCRIPTION

Subscription to Journal of Nutrition and Dietetics is either on an institutional (campus) basis or a personal basis. Subscriptions are on a calendar year basis. Subscriptions will be renewed automatically unless a notification of cancellation has been received before 1st December before the start of the new subscription year. Please note: Personal subscribers must provide a home delivery and invoice address.

 

The following subscription options are available for Journal of Nutrition and Dietetics:

Individual Offers

Yearly subscription Journal of Nutrition and Dietetics (print and online): USD 25

Yearly subscription Journal of Nutrition and Dietetics (print only): USD 15

Yearly subscription Journal of Nutrition and Dietetics (online only): USD 10

Institutional Offers

Yearly subscription Journal of Nutrition and Dietetics (print and online): USD 100

Yearly subscription Journal of Nutrition and Dietetics (print only): USD 75

Yearly subscription Journal of Nutrition and Dietetics (online only): USD 25

 

For more questions related to subscriptions contact:

Journal of Nutrition and Dietetics

P.O. Box, 20436-00100,

Nairobi, Kenya

Tel. (+254) 02608882

kndijournal@kndi.institute

JOURNAL OF NUTRITION & DIETETICS : RECOMMENDATION

JOURNAL OF NUTRITION & DIETETICS : CONFERENCES