Dataset Information

Nutritionally Optimized, Culturally Acceptable, Cost-Minimized Diets for Low Income Ghanaian Families Using Linear Programming.

ABSTRACT: The Ghanaian population suffers from a double burden of malnutrition. Cost of food is considered a barrier to achieving a health-promoting diet. Food prices were collected in major cities and in rural areas in southern Ghana. Linear programming (LP) was used to calculate nutritionally optimized diets (food baskets (FBs)) for a low-income Ghanaian family of four that fulfilled energy and nutrient recommendations in both rural and urban settings. Calculations included implementing cultural acceptability for families living in extreme and moderate poverty (food budget under USD 1.9 and 3.1 per day respectively). Energy-appropriate FBs minimized for cost, following Food Balance Sheets (FBS), lacked key micronutrients such as iodine, vitamin B12 and iron for the mothers. Nutritionally adequate FBs were achieved in all settings when optimizing for a diet cheaper than USD 3.1. However, when delimiting cost to USD 1.9 in rural areas, wild foods had to be included in order to meet nutritional adequacy. Optimization suggested to reduce roots, tubers and fruits and to increase cereals, vegetables and oil-bearing crops compared with FBS. LP is a useful tool to design culturally acceptable diets at minimum cost for low-income Ghanaian families to help advise national authorities how to overcome the double burden of malnutrition.

SUBMITTER: Nykanen EA

PROVIDER: S-EPMC5946246 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Nutritionally Optimized, Culturally Acceptable, Cost-Minimized Diets for Low Income Ghanaian Families Using Linear Programming.

Nykänen Esa-Pekka A EA Dunning Hanna E HE Aryeetey Richmond N O RNO Robertson Aileen A Parlesak Alexandr A

Nutrients 20180407 4

The Ghanaian population suffers from a double burden of malnutrition. Cost of food is considered a barrier to achieving a health-promoting diet. Food prices were collected in major cities and in rural areas in southern Ghana. Linear programming (LP) was used to calculate nutritionally optimized diets (food baskets (FBs)) for a low-income Ghanaian family of four that fulfilled energy and nutrient recommendations in both rural and urban settings. Calculations included implementing cultural accepta ...[more]

PMID: 29642444

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Project description:BACKGROUND:Lactating women need to consume a high-quality diet to replete nutrient stores depleted during pregnancy and to ensure sufficient nutrition for breastfeeding. However, several studies reported suboptimal dietary quality and nutrient intake of lactating mothers in China. The objectives of this study was to apply dietary modeling method to develop individualized optimal diets, which meet the nutrient requirements for lactating women in urban China. METHODS:Data were collected from a sample of 576 lactating women from 0 to 240 days postpartum during the Maternal Infant Nutrition Growth study conducted between 2011 and 2012 in three cities including Beijing, Guangzhou, and Suzhou. Dietary intake data were collected with an interviewer-administered 24-h survey. Linear programming was applied to develop dietary plans that meet recommendations for lactation women in the China Dietary Reference Intakes 2013 and the Chinese Dietary Guideline 2016, while with least deviation from the observed dietary intake. RESULTS:Through dietary modeling, individual optimal diets were developed for 576 lactating women. The optimal diets met all the food and nutrient intake constraints set in the linear programming models. The large difference between observed and optimized diets suggests that the nutrient needs of lactating mothers in China may only be met after substantial dietary changes. In addition, the analysis showed that it was difficult to meet the recommended intake for six nutrients: vitamin A, vitamin B1, vitamin B6, calcium, selenium, and dietary fiber. Moreover, four clusters in the optimized diets were identified by K-means cluster analysis. The four clusters confirmed that the optimal diets developed by linear programming could characterize the variety in dietary habits by geographical regions and duration of lactation. CONCLUSION:Linear programming could help translate nutrient recommendations into personal diet advices for a sample of urban lactating mothers from China. The study showed that dietary modeling is helpful to support healthy eating of lactation women by translating dietary guidelines into personalized meal plans. TRIAL REGISTRATION:The Maternal Infant Nutrition Growth study was registered in ClinicalTrials.gov with identifier NCT01971671 . Registration date October 29, 2013.

Project description:Diabetes risk is extremely high for Latinos from low-income households. Health guidelines recommend that individuals learn strategies to self-manage their diabetes, but getting people to adopt required lifestyle changes is challenging and many people are not able to prevent their pre-diabetes from escalating or effectively control their diabetes. Systematic reviews show that culturally competent self-management programs can significantly improve diabetes outcomes and different models for culturally competent programming have been developed.This patient-engaged study will compare the effectiveness of two distinct evidence-based models for culturally competent diabetes health promotion at two sites that serve a large Latino patient population from low-income households: 1) The Diabetes Self-Management Support Empowerment Model, an educational session approach, and 2) The Chronic Care Model, a holistic community-based program. Data collection will involve interviews, focus groups, surveys and assessments of each program; and testing of patient participants for A1c, depression, Body Mass Index (BMI), and chronic stress with hair cortisol levels. We will recruit a total of 240 patient-social support pairs: Patients will be adults (men and women over the age of 18) who: 1.) Enter one of the two diabetes programs during the study; 2.) Self-identify as "Latino;" 3.) Are able to identify a social support person or key member of their social network who also agrees to participate with them; 4.) Are not pregnant (participants who become pregnant during the study will be excluded); and 5.) Have household income 250% of the Federal Poverty Level (FPL) or below. Social supports will be adults who are identified by the patient participants.Improved capacity for diabetes self-management measured through improvements in diabetes knowledge and diabetes-related patient activation.Successful diabetes self-management as measured by improvements in A1c, depression scale scores, BMI, and circulating levels of cortisol to determine chronic stress.Our hypothesis is that the program model that interfaces most synergistically with patients' culture and everyday life circumstances will have the best diabetes health outcomes.This study was registered with ClinicalTrials.gov on December 16, 2016 (Registration # NCT03004664 ).

Dataset Information

Nutritionally Optimized, Culturally Acceptable, Cost-Minimized Diets for Low Income Ghanaian Families Using Linear Programming.

Publications

Nutritionally Optimized, Culturally Acceptable, Cost-Minimized Diets for Low Income Ghanaian Families Using Linear Programming.

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