Article

Seasonal Dietary Intakes and Socioeconomic Status among Women in the Terai of Nepal

Journal of Health Population and Nutrition (Impact Factor: 1.04). 06/2014; 32(2):198-216.
Source: PubMed

ABSTRACT

Despite widespread nutritional deficiencies, investigations of usual diet in rural South Asia remain sparse. The present study characterizes year-round and seasonal dietary patterns of women in the Terai of Nepal by sociodemographic status, using a novel, weekly single-visit and usual food frequency questionnaire that links recall to the agricultural season. The study was conducted across seasons in 2006-2008 among 15,899 women of reproductive age in Sarlahi district. Intakes were tabulated for all foods, overall and by socioeconomic status (SES), and in and out of season, as appropriate. Foods consumed regularly [median (interquartile range) weekly frequency] were rice [13 (7-13)], potatoes [10 (5-13)], legumes [6 (2-9)], and vegetable oil [13 (13-13)]. Animal products were infrequently consumed [1 (0-2) time per week] as were fruits and vegetables, most with a median weekly intake frequency of 0. Higher SES was associated with more frequent consumption of most food-groups, including in-season fruits and vegetables. Diets of women in the Terai of Nepal lack diversity and, likely, nutrient adequacy, which may pose health risks.

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Available from: Rebecca F Kramer, Dec 19, 2014
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    • "All intake frequencies and units for reported usual and past 7-day intakes were converted to times per week. An in-season period was assigned to each seasonal vegetable and fruit (Campbell et al. 2014) and interviews were classified accordingly as in-season or out-of-season for each food. The in-season period for each food was divided into thirds, and interviews in the middle third of the in-season period were classified as " in peak season " . "
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    ABSTRACT: Novel dietary assessment methods are needed to study chronic disease risk in agrarian cultures where food availability is highly seasonal. In 16,320 rural Nepalese women, we tested a novel food frequency questionnaire, administered once, to assess past 7-day intake and usual frequency of intake throughout the year for year-round foods and when in season for seasonal foods. Spearman rank correlations between usual and past 7-day intakes were 0.12-0.85 and weighted kappa statistics, representing chance-corrected agreement, were 0.10-0.80, with better agreement for frequently consumed foods. The questionnaire performed well, but may require refinement for settings of extremely low dietary diversity.
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    ABSTRACT: Background: Observational studies and meta-analyses suggested that increased total fruits and vegetables consumption have a protective role in incidence of type 2 diabetes mellitus (T2DM). However, we still don't know whether the subtypes, such as citrus fruits and cruciferous vegetables (CV), have a preventive role. Methods: We systematically searched the MEDLINE and EMBASE databases up to December 31, 2014. Summary relative risks (SRRs) and 95% confidence intervals (CIs) were calculated using random-effects models. Results: Seven distinct prospective cohort studies (five articles) were identified for this study. A total of 16,544 incident cases of type 2 diabetes were ascertained among 306,723 participants with follow-up periods ranging from 4.6 to 24 years. Based on four prospective cohort studies, we found that overall, consumption of CV had a protective role in the T2DM incidence (highest vs. lowest analysis: SRR=0.84, 95% CI: 0.73 to 0.96), with evidence of significant heterogeneity (P=0.09, I(2)=54.4%). This association was independent of the main risk factors for cardiovascular disease: smoking, alcohol use, BMI, and physical activity etc. Consumption of citrus fruits did not have a protective role in the T2DM development (highest vs. lowest analysis: SRR=1.02, 95% CI: 0.96 to 1.08), with no evidence of significant heterogeneity (P=0.49, I(2)=0). Conclusions: Higher consumption of CV, but not citrus fruits, is associated with a significantly decreased risk of type 2 diabetes. Further large prospective studies are needed to elucidate both relationships.
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