Socioeconomic determinants of dietary patterns in low- and middle-income countries: a systematic review

The synbiotic concept was first introduced, along with prebiotics, as “mixtures of probiotics and prebiotics that beneficially affect the host by improving the survival and implantation of live microbial dietary supplements in the gastrointestinal tract, by selectively stimulating the growth and/or by activating the metabolism of one or a limited number of health-promoting bacteria, thus improving host welfare” (Gibson & Roberfroid 1995). Since, there have been many in vitro and in vivo studies focusing on the application of prebiotics, firstly in health and gradually in disease states. Only recently have studies on synbiotics started to emerge with the main focus being on applications against disease. Here, we review the current literature, with the main focus on in vivo human studies.

Synbiotics in Health and Disease

A daily intake of 5 portions of fruit and vegetables (FV) is recommended for protection against non-communicable diseases (NCDs). Inadequate FV intake is a global problem but resource-poor countries like Tanzania are most deprived and constitute settings where little is known for informing public health interventions. This study aimed to describe the prevalence of inadequate FV intake, frequency of FV intake, portions of FV intake and their associations with socio-demographic/lifestyle factors in South-Eastern Tanzania. Data on FV dietary indicators, socio-demographic factors, smoking, alcohol and healthcare use were collected from 7953 participants (≥15 years) of the population-based MZIMA open community cohort (2012–2013). Multivariable logistic regression was used to examine associations between FV intake outcomes and their socio-demographic/lifestyle determinants. Most (82%) of the participants did not meet the recommended daily FV intake While only a fraction consumed fruits daily (15.5%), almost half consumed vegetables daily (44.2%). However, the median (IQR) number of vegetable portions consumed was lower (2(1)/person/day) than that for fruits (2(2)/person/day) People with higher education were more likely to consume fruits daily. Independent correlates of inadequate FV intake included young age, being male, low education, low-income occupations, low alcohol, high tobacco and low healthcare use. Public health interventions should target the socio-economically deprived and culturally-rooted preferences while prioritizing promotion of vegetable for most immediate gain in overall FV intake.

https://www.mdpi.com/2072-6643/10/2/222/pdf

Insufficient Fruit and Vegetable Intake in a Low- and Middle-Income Setting: A Population-Based Survey in Semi-Urban Tanzania

INTRODUCTION Folic acid (FA) deficiency is associated with neural tube defects (NTD). In a non-risk pregnancy, The Danish National Board of Health recommends FA supplementation from planned pregnancy until three months after conception. We explored pregnant women's knowledge about and actual supplementation with FA and related this to education, number of pregnancies and age. MATERIAL AND METHODS Eighty-four consecutive pregnant women with a midwife consultation were included in the period 25-28 August 2008. All filled in a unified questionnaire. RESULTS 82% had knowledge of FA supplementation and 89% received FA supplementation. 51% followed national recommendations. We found a statistically significant correlation between higher educational level and knowledge about FA supplementation, actual supplementation of FA and FA supplementation in accordance with national recommendations. No statistical associations were found between number of pregnancies or age and any FA-related parameters. Family, friends, general practitioner (GP) and the internet were the main information sources. CONCLUSION Correct FA supplementation is quite low; conversely, knowledge about and actual FA supplementation are fairly high. Further intervention is necessary to increase the level of correct FA supplementation. Women with a low educational level--which may herald low socio-economic status--seem to form a suitable target group for information campaigns. Multiple pregnancies or higher age should not be perceived as indicators of a higher information level. Dissemination of information to the pregnant women including family, friends, GPs or the internet is recommended.

Folic acid supplementation in pregnant women

Identifying the difference in barriers and motivators between middle-age and older adults could contribute toward the development of age-specific health promotion interventions. The aim of this review was to synthesize the literature on barriers and motivators for physical activity in middle-aged (50-64 years) and older adults (65-70 years). The review examined qualitative and quantitative studies using the theoretical domain framework as the guiding theory. The search generated 9400 results from seven databases. A total of fifty-five articles meeting the inclusion criteria. Results indicate that barriers are comparable across the two age groups with environmental factors and resources being the most commonly identified barriers. In older adults, social influences, reinforcement and assistance in managing change were the most identified motivators. Middle-aged identified goals settings, believe that activity will be beneficial and social influences were most important. Findings can be used by professionals to encourage engagement with and adherence to physical activity.

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Barriers and motivators of physical activity participation in middle-aged and older-adults – a systematic review

Introduction Coronavirus pandemic causes stress and anxiety for pregnant women worldwide. The present study was conducted for the path analysis of the relationship among fear and anxiety caused by coronavirus, pregnancy experience, and the mental health of pregnant women. Methods This cross-sectional study was conducted on 222 pregnant women who were referred to Kamali Hospital in Alborz province in 2020. The eligible individuals entered the study through convenience sampling, and data were collected using five questionnaires including the Fear of COVID-19 Scale, the Anxiety of COVID-19 Scale, the pregnancy experiences Scales, Depression Anxiety Stress scale, and demographic checklist. The obtained data were then analyzed using SPSS-16 and Amos software. Results According to results of the path analysis, the anxiety of COVID-19 and concerns during pregnancy were variables that were positively and significantly correlated with mental health only through one path, which was direct, and anxiety of COVID-19 had also the highest positive direct correlation among them (B = 0.32). The next variable was the happiness during pregnancy experiencing, which had a significantly negative and direct correlation with mental health disorder (B = 0.29). Moreover, fear of COVID-19 through the mediating concerns of pregnancy experiences was shown to have a significant positive relationship with mental health through an indirect path (B = 0.05). Conclusion Based on the result of this study, it is necessary to pay more attention to the mental health of pregnant women during a pandemic. In addition, it is recommended to provide a virtual training group to reduce anxiety caused by coronavirus and pregnancy concerns, as well as emphasizing the feeling of enjoying happiness caused by pregnancy experience during a pandemic.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/brb3.1835

The relationship among fear and anxiety of COVID-19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model.

Background: There is substantial evidence that low consumption of fruit and vegetables (FV) is a major risk factor for many chronic diseases. The aim of this study was to assess FV consumption and the variables that influence it among elderly individuals in Iran aged 60 and over. Methods: This was a cross-sectional study to investigate FV intake by a randomly-selected sample of members of elderly centers in Tehran, Iran. A multidimensional questionnaire was used to collect data on demographic characteristics, daily consumption of FV, knowledge, self-efficacy, social support, perceived benefits, and barriers against FV. Data were analyzed using t-tests, one way analysis of variance, Pearson correlation, and logistic regression. Results: In total, 400 elderly individuals took part in the study. The mean age of the participants was 64.07 (SD = 4.49) years, and most were female (74.5%). The mean number of FV servings per day was 1.76 (SD = 1.15). Ninetyseven percent of participants (n = 388) did not know the recommended intake was at least five servings of FV per day. Similarly, 88.3% (n = 353) did not know the size of a single serving. The most frequent perceived benefits of and barriers against FV consumption were availability and expense, respectively. Knowledge (OR = 0.59, 95% CI = 0.39-0.88), perceived benefits (OR = 0.92, 95% CI = 0.88-0.96) and barriers (OR = 1.08, 95% CI = 1.04-1.14), selfefficacy (OR = 0.89, 95% CI = 0.83-0.95) and family support (OR = 0.91, 95% CI = 0.83-0.99) were significantly associated with fruit and vegetable consumption. Conclusion: The findings of this study indicate that FV intake among elderly individuals in Iran was lower than the recommended minimum of five daily servings and varied greatly with age, marital status, educational attainment, and income level. The results also indicated that low perceived benefits, low self-efficacy, and perceived barriers could lead to lower consumption of FV. It seems that in order to improve FV consumption among elderly individuals in Iran, raising awareness, improving perception of benefits and enhancing self-efficacy regarding FV consumption should receive more attention. Indeed, it is essential to plan health education programs and nutritional interventions for this group of the population.

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Consumption of fruit and vegetables among elderly people: a cross sectional study from Iran

Background: Physical inactivity is one of the leading causes of major chronic disease, which contributes substantially to the global burden of disease, death and disability. This study examined physical activity in a randomly selected sample of elderly people in Tehran, Iran. Methods: A random sample of 400 elderly people aged 60 years and over was selected through multistage sampling. A multi-sectional questionnaire that contained demographic characteristics, physical activity knowledge, benets, barriers, self- efcacy, and readiness stage was used. Physical activity was measured by questions retrieved from the Physical Activity Scale for the Elderly. Results: This study showed knowledge, perceived benets, and self-efcacy could predict physical activity stage of change (P<0.001). Sixty-two percent of participants reported laziness as the most important barrier for not engaging in physical activity. Meeting new people (74%), having fun (71.8%), and contacting friends (67.73%) were the most prevalent reasons for partici- pating in physical activity. Conclusion: According to this study, individuals with higher knowledge, perceived benets and self-efcacy were more likely to engage in physical activity. Furthermore, those who perceived lower barriers towards this behavior were more physically active.

Physical activity among a sample of Iranians aged over 60 years: an application of the transtheoretical model.

Background
The benefit of FV intake in old age is well documented. However, there is evidence that old people do not consume enough FV. The purpose of this study was to evaluate the effectiveness of a tailored nutrition intervention that aimed to increase the FV intake among elderly Iranians aged 60 and over.

/pdf/fruit-and-vegetables-intake-among-elderly-iranians-a-theory-lbc4w2qvvt.pdf

Fruit and vegetables intake among elderly Iranians: a theory-based interventional study using the five-a-day program

Patients and Methods: In this cross-sectional study, 312 healthy and nonsmoker adolescent pregnant women with gestational age (GA) of 37-40 weeks were chosen by random sampling, and were followed until delivery. A complete history was obtained from women. In addition, clinical examination and Hb test were performed. After birth, the associations between Hb concentration during pregnancy and birth outcomes were investigated. Statistical analyses were performed using SPSS software by t-test, chi-square and ANOVA. Results: In total, about 23.2 % were anemic, 58% had normal level of Hb (11-13.2 g/dL) and 18.8% had Hb > 13.2 g/dL. The mean birth weight was 3197.8 ± 398.25 grams and it was more in mothers with Hb = 10.5-12.5 g/dL than others (Hb 12.5 g/dL) (P 12.5 g/dL) was more than others. Conclusions: Abnormal Hb concentrations increase the risk of adverse birth outcomes such as low birth weight (LBW) and low Apgar scores in pregnant adolescents, so intensive care is recommended for this group of pregnant women.

/pdf/impact-of-maternal-hemoglobin-concentration-on-fetal-eqp38iqrjc.pdf

Leili Salehi

Papers

The relationship among fear and anxiety of COVID-19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model.

Consumption of fruit and vegetables among elderly people: a cross sectional study from Iran

Physical activity among a sample of Iranians aged over 60 years: an application of the transtheoretical model.

Fruit and vegetables intake among elderly Iranians: a theory-based interventional study using the five-a-day program

Impact of Maternal Hemoglobin Concentration on Fetal Outcomes in Adolescent Pregnant Women