Odeafo Asamoah-Boakye

Renal impairment (RI) is a prevalent condition characterised by suboptimal kidney function, often leading to undernutrition and significant metabolic disturbances. The global rise in RI, especially in developing countries, highlights the need for effective nutritional assessment tools. A cross- sectional descriptive study was conducted at the Nephrology Unit of Komfo Anokye Teaching Hospital (KATH) in Ghana to compare the effectiveness of three nutritional assessment tools – the Mini Nutritional Assessment (MNA), Subjective Global Assessment (SGA), and Malnutrition Universal Screening Tool (MUST) – in predicting nutritional-related clinical outcomes among 110 renal patients. Nutritional status was assessed using the MNA, SGA, and MUST tools. Data were analysed using SPSS version 23. The study found that 49.1% of patients were malnourished according to the MNA, compared to 16.4% by MUST and 12.7% by SGA. Significant associations were observed between the MNA scores and clinical outcomes such as declined food intake, weight- change, and BMI. The MNA showed superior predictive capability for these outcomes compared to the SGA and MUST. There was a significant gender and age difference in nutritional status, with female patients and those aged 51-60 years being at higher risk of malnutrition. The MNA was found to be the most effective tool in predicting nutritional-related clinical outcomes in renal patients, supporting its use in clinical settings for early identification and intervention. Regular training of healthcare professionals in using the MNA is recommended to enhance early detection and management of malnutrition, ultimately improving patient outcomes.

Background: Iron Deficiency Anaemia (IDA) is reportedly high in pregnant adults and the causes well studied. However, among pregnant teenagers, the levels and associated factors of IDA are not fully understood.Methods: In a prospective cohort study among Ghanaian pregnant teenagers, aged 13–19 years, IDA prevalence and associated factors were investigated. Sociodemographic data, household hunger scale (HHS), lived poverty index (LPI), FAO’s women’s dietary diversity score (WDDS) and interventions received during antenatal care (ANC) were obtained from 416 pregnant teenagers in Ashanti Region, Ghana. Micronutrient intakes using a repeated 24-hour dietary recall, and mid-upper arm circumference (MUAC) were determined and blood samples analysed for haemoglobin (Hb), serum levels of ferritin, prealbumin, vitamin A, total antioxidant capacity (TAC), C-reactive protein (CRP), and zinc protoporphyrin (ZPP).Results: Anaemia (Hb cutoff <11.0 g/dL) was 57.1%; deficient systemic supply of iron stores (31.4%), depleted body stores of iron (4.4%), inadequate dietary iron intake (94.5%), and inadequate multiple micronutrient intakes (49.5%), were all notable among study participants. Between-subject effects using Generalized Linear Modelling indicated malaria tablet given at ANC (p = 0.035), MUAC (p = 0.043), ZPP (p<0.001), ZPP/Hb ratio (p<0.001) and depleted body iron stores (DBIS) (p<0.001) to significantly affect Hb levels. Pregnant teenagers with a high ZPP/Hb ratio (OR = 9.7, p<0.001, 95%CI = 6.0–15.8) had increased odds of being anaemic compared to those with normal ZPP/Hb ratio. Participants who were wasted (OR = 1.2, p = 0.543, 95%CI = 0.6–2.3), and those with depleted iron stores (OR = 3.0, p = 0.167, 95%CI = 0.6–14.6) had increased odds of being anaemic. Participants who experienced hunger were close to 3 times more likely (OR = 2.9, p = 0.040, 95%CI = 1.1–7.8) for depleted iron stores, compared to those who did not experience hunger. Also, participants with inadequate multiple micronutrients intakes (OR = 2.6, p = 0.102, 95%CI = 0.8–8.4), and those with low serum levels of ferritin (OR = 3.3, p = 0.291, 95%CI = 0.4–29.2) had increased odds of depleted body iron stores.Conclusions: IDA is common among pregnant teenagers and the related factors include malaria tablets given at ANC, maternal hunger, maternal MUAC, a deficient systemic supply of iron, depleted body iron stores, ZPP, and ZPP/Hb ratio. Appropriate interventions are urgently needed to address the causes of IDA among pregnant teenagers.

Background: Dietary diversity, a qualitative measure of dietary intake, which reflects the variety of foods consumed has been recommended to assuage nutritional problems related to insufficient micronutrients, and food insecurity. To better understand the underlying factors for poor birth outcomes in Ghana, we assessed factors associated with dietary diversity among rural and urban pregnant adolescents in the Ashanti Region of Ghana.Methods: As part of a larger longitudinal cohort of 416 pregnant adolescents, the FAO minimum dietary diversity for women index was used to determine the dietary diversity score (DDS) of the participants from a previous days’ 24-hour dietary recall data. The household hunger scale (HHS) and lived poverty index (LPI) were used to determine hunger and socioeconomic status. Eating behavior and socio-demographic data were gathered using interviewer-administered questionnaires.Results: The mean age of the participants was 17.5 (±1.4) years with an MDD-W of 4.4 and 56% recording inadequate MDD score. More rural (63.6%) than urban dwellers (50.6%) had inadequate DDS (p = 0.008). Among all the multiple variables tests of associations on dietary diversity, only hunger status (p = 0.028) and both food aversion and poverty status (p = 0.003) had a significant effect on the adolescents’ dietary diversity. Rural dwelling adolescents (AOR = 1.7, p = 0.035, 95% CI = 1.0–2.6) recorded higher odds for inadequate DD compared with the urban respondents. Pregnant adolescents with severe hunger had higher odds (Unadjusted OR = 1.9, p = 0.053, 95% CI 1.1–3.8) for inadequate dietary diversity compared with those with no hunger.Conclusions: Inadequate DD is common among pregnant adolescents in this study and is associated with rural living, food insecurity, poverty, and food craving. Livelihood support for pregnant teenagers and nutrition education are recommended interventions to improve dietary quality and limit the consequences of poor dietary diversity.

Background: Inadequate nutritional status during pregnancy can lead to adverse birth outcomes but this is more so for pregnant adolescents as they require nutrients to meet their needs for growth and that of the foetus. The study examined the relationship between nutritional status and birth outcomes among Ghanaian teenagers in rural and urban districts of the Ashanti Region, Ghana.Methods In this prospective cohort study, 416 pregnant teenagers recruited at hospitals/health centres during antenatal care were followed until delivery. Data on weight, height (for body mass index), mid-upper arm circumference (MUAC), and nutrients intake using a repeated 24-hour dietary recall were determined. Blood samples were also taken and analysed for haemoglobin (Hb), serum levels of ferritin, prealbumin, vitamin A, total antioxidant capacity (TAC), C-reactive protein (CRP), and zinc protoporphyrin (ZPP). Birth weight, gestational age at birth, type of delivery, and outcome of delivery were collected as each teenager gave birth. Data were analysed using Chi-square (Fisher’s exact) analysis, t-test, two-way ANOVA and multiple linear regression. Results: 15.9% had low birth weight, 12.5% had preterm birth, 11.5% had a postpartum haemorrhage, and 3.1% neonatal deaths. Majority of the participants had inadequate intakes of energy (81.4%), protein (77.2%), vitamins A (97.1%) and E (97.7%), calcium (99.8%), iron (97.6%), folate (93.0%), zinc (83.7%), riboflavin (88.4%), thiamin (74.4%), and fiber (74.4%) intakes. Anaemia and wasting prevalence were 57.1% and 27.8%. Between-subject effects determined using Generalized Linear Modelling indicated MUAC (p=0.058), and gestational age at delivery (p=0.023) significantly affected birth weight. A multiple linear regression analysis indicated MUAC (β=0.283, p=0.002), BMI (β=0.221, p=0.015), gestational age (β=0.285, p2=1.941).Conclusions: Inadequate nutrients intake, anaemia, and LBW were found in these pregnant teenagers. Maternal MUAC, gestational age, and serum ZPP were associated with birth weight. Interventions for improving the nutritional status of teenagers before and during pregnancy are urgently needed to reduce the risk of adverse birth outcomes.

Nutrients are critical for optimal brain development, and good nutritional status is associated with cognitive development and improvement. The relationship between micronutrients intake and cognition in Ghanaian school‐aged children has not been studied. The study investigated dietary intakes of micronutrients and cognition test performance of school‐aged children. A cross‐sectional study was undertaken among 438 school children, aged 9–13 years from ten randomly selected basic schools in Kumasi, Ghana. Socio‐demographic data were obtained from a structured questionnaire. Dietary intakes of iron, zinc, vitamin B₆, folate, vitamin B₁₂, and vitamin A were determined from repeated 24‐hr dietary recall data from 351 children, while cognition test was performed using a Raven's Coloured Progressive Matrices (RCPM), a 36‐question test. Among 351 children, 156 (44.4%) had inadequate zinc intake, whereas 96 (27.4%) had inadequate iron intake. More than 1 in 2 children had inadequate vitamin A intake while 55.8% and 53.0% had inadequate vitamin B₁₂ and folate intakes, respectively. More school‐aged boys (66.3%) than girls (46.8%) had inadequate vitamin B₁₂ intake (χ² = 13.393, p < .001), while for iron, folate, vitamin B₆, zinc, and vitamin A, the differences were not significant. Mean RCPM test score differed significantly between school type (p < .001), but did not differ between the different ages, and between children with adequate and inadequate iron, zinc, vitamin B_12, vitamin B₆, and vitamin A intakes, except for folate intake (p = .050). Weak positive significant associations were observed between RCPM test score and zinc and folate intakes (p = .050). Dietary micronutrient intakes were inadequate in majority of these children, which put them at risk of weakened immune system and poor health, but did not show significant associations with RCPM performance. Further studies using other forms of cognition tests may help confirm our findings, and provide the impetus for the necessary interventions.