Increasing prosperity linked to unhealthy eating patterns in Kenyan youth

The increase in obesity in lower-middle-income countries (LMIC) is largely thought to be affected by lifestyle transition away from traditional diets toward unhealthy Western dietary patterns that follow economic development. This study in the Journal of Nutrition Education and Behavior, published by Elsevier, collected data on eating and physical activity behaviors from families in two socioeconomically-different communities in Nairobi, Kenya. Researchers found that increasing prosperity is linked to unhealthy eating patterns in Kenyan preadolescents.

"Dietary habits of people in Kenya are changing from traditional staple foods toward refined grains, especially in urban environments," says lead author Noora Kanerva, PhD, Department of Food and Nutrition, University of Helsinki, Helsinki, Finland. "Signs of lifestyle transition can also be seen in physical activity where rural children were more active and engaged significantly less in playing screen games."

This in-depth study collected sociodemographic data from 149 households using questionnaires that asked about level of education, household living conditions, and ownership of assets in the house. Preadolescents’ height and weight were measured and information about their diet was collected using a seven-day food frequency questionnaire with cultural-specific foods as well as locally available packaged foods such as pizza, noodles, pancakes, etc. Study participants also wore accelerometers to measure physical activity.

Three dietary patterns emerged from the data: snacks, fast food, and meat; dairy and plant protein; and vegetables and refined grains. Consumption of food often deemed unhealthy such as snacks and fast food was more frequent among preadolescents whose families were wealthier. The largest difference was seen for sodas and juices (including both sweetened and unsweetened), consumed eight times more often among preadolescents in the highest wealth index compared with the lowest. Moderate-to-vigorous physical activity was not associated with any dietary pattern.

“Based on our observation, the dietary habits of preadolescents living in the urban environment of Nairobi, Kenya—which was upgraded to an LMIC less than 10 years ago—do not yet resemble high-income countries in which preadolescents from less wealthy families would have unhealthier diets compared with preadolescents from wealthier families,” explains Dr. Kanerva. “As LMIC are still in an early phase of their lifestyle transition, the expansion of obesity to epidemic proportions may be prevented if the correct actions are known and taken shortly.”

Researchers suggest that interventions promoting healthy lifestyles could be conducted using peer counselors and lay health educators known as Community Health Volunteers (CHV). In Kenya, the naturally occurring social network of CHVs is indigenous to the community and offers culturally relevant and effective social support. CHVs belong to community health units responsible for making weekly home visits to households within designated geographical areas. Additionally, the widespread coverage of mobile phone networks in Kenya makes Mobile Health interventions, currently being used for family planning and infectious disease management, feasible.

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Notes for editors

The article is "Wealth and Sedentary Time Are Associated With Dietary Patterns Among Preadolescents in Nairobi City, Kenya," by Noora Kanerva, PhD; Lucy Joy Wachira, PhD; Noora Uusi-Ranta, MS; Esther L. Anono, BS; Hanna M. Walsh; Maijaliisa Erkkola, PhD; Sophie Ochola, PhD; Nils Swindell, PhD; Jatta Salmela, PhD; Henna Vepsäläinen, PhD; Gareth Stratton, PhD; Vincent Onywera, PhD; and Mikael Fogelholm, PhD. (https://doi.org/10.1016/j.jneb.2023.02.001). It appears in the Journal of Nutrition Education and Behavior, volume 55, issue 5 (May 2023), published by Elsevier.

The article is openly available at https://www.jneb.org/article/S1499-4046(23)00026-X/fulltext.

Full text of the article is also available to credentialed journalists upon request; contact Eileen Leahy at +1 732 238 3628 or [email protected] to obtain a copy. To schedule an interview with the author(s), please contact Noora Kanerva, PhD, at [email protected].

An audio podcast featuring an interview with Dr. Kanerva and other information for journalists are available at https://www.jneb.org/content/media. Excerpts from the podcast may be reproduced by the media with permission from Eileen Leahy.

About the Journal of Nutrition Education and Behavior (JNEB)

The Journal of Nutrition Education and Behavior (JNEB), the official journal of the Society for Nutrition Education and Behavior (SNEB), is a refereed, scientific periodical that serves as a resource for all professionals with an interest in nutrition education and dietary/physical activity behaviors. The purpose of JNEB is to document and disseminate original research, emerging issues, and practices relevant to nutrition education and behavior worldwide and to promote healthy, sustainable food choices. It supports the society's efforts to disseminate innovative nutrition education strategies, and communicate information on food, nutrition, and health issues to students, professionals, policy makers, targeted audiences, and the public.

The Journal of Nutrition Education and Behavior features articles that provide new insights and useful findings related to nutrition education research, practice, and policy. The content areas of JNEB reflect the diverse interests of health, nutrition, education, Cooperative Extension, and other professionals working in areas related to nutrition education and behavior. As the Society's official journal, JNEB also includes occasional policy statements, issue perspectives, and member communications. www.jneb.org

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