A Cross-Sectional Study on the Diet and Nutritional Status of Adolescent Girls in Zambézia Province, Mozambique (the ZANE Study): Design, Methods, and Population Characteristics

Liisa Korkalo, Riitta Freese, Lourdes Fidalgo, Kerry Selvester, Carina Ismael, Marja Mutanen, Liisa Korkalo, Riitta Freese, Lourdes Fidalgo, Kerry Selvester, Carina Ismael, Marja Mutanen

Abstract

Background: There is very little published work on dietary intake and nutritional status of Mozambicans. We conducted a population-based cross-sectional study on the diet and nutritional status of adolescent girls in different types of communities in Zambézia Province, Central Mozambique, in two distinct seasons.

Objective: The purpose of this paper is to present the design, methods, and study population characteristics of the Estudo do Estado Nutricional e da Dieta em Raparigas Adolescentes na Zambézia (the ZANE Study).

Methods: Data was collected in January-February 2010 ("hunger season") and in May-June 2010 ("harvest season"). A total of 551 girls in the age group 14-19 years old were recruited from one urban area and two districts (district towns and rural villages). The study protocol included a background interview, a 24-hour dietary recall interview, a food frequency questionnaire, anthropometric measurements, bioimpedance, hemoglobin measurement, and venous blood, urine, buccal cell, and fecal sampling.

Results: Adolescent motherhood was common in all study regions. Stunting prevalence for the total study population as a weighted percentage was 17.8% (95/549; 95% CI 14.3-22.0) with no regional differences. Overweight was found mainly in the urban area where the prevalence was 12.6% (20/159; 95% CI 7.5-17.6), thinness was rare. There were regional differences in the prevalence of malaria parasitemia and intestinal helminth infestation, but not human immunodeficiency virus.

Conclusions: The fully analyzed data from the ZANE Study will yield results useful for setting priorities in nutrition policy and further research on the diet and nutritional status in Mozambique and other countries with similar nutritional problems.

Trial registration: ClinicalTrials.gov: NCT01944891; http://www.clinicaltrials.gov/ct2/show/NCT01944891 (Archived by WebCite at http://www.webcitation.org/6L9OUrsq8).

Keywords: Mozambique; adolescent girls; cross-sectional study; diet; methods; nutritional status; sub-Saharan Africa.

Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Map of Zambézia Province. The original maps are from d-maps.com [18] and Instituto Nacional de Estatística (Anuário Estatístico, Província da Zambézia, 2003).
Figure 2
Figure 2
Implemented sampling design. The population figures are from the 2007 Census. y=years.
Figure 3
Figure 3
Example of food photographs used in portion size estimation: 270 g, 408 g, and 610 g of thick maize porridge.

References

    1. UNDP . Human development report 2013. New York: UNDP; 2013. [2014-02-12]. .
    1. Moçambique Inquérito Demográfico e de Saúde 2011. Calverton, Maryland: Ministerio da Saude, Instituto Nacional de Estatística, ICF International; 2013. .
    1. World Bank World Bank. 2012. World development indicators 2012 .
    1. UNICEF . Child poverty and disparities in Mozambique 2010. Maputo: UNICEF; 2011. [2014-01-09]. .
    1. UNICEF. 2013. Improving child nutrition-the achievable imperative for global progress .
    1. Vorster HH, Kruger A, Margetts BM. The nutrition transition in Africa: Can it be steered into a more positive direction? Nutrients. 2011 Apr;3(4):429–441. doi: 10.3390/nu3040429.
    1. Popkin BM, Adair LS, Ng SW. Global nutrition transition and the pandemic of obesity in developing countries. Nutr Rev. 2012 Jan;70(1):3–21. doi: 10.1111/j.1753-4887.2011.00456.x.
    1. Abrahams Z, McHiza Z, Steyn NP. Diet and mortality rates in Sub-Saharan Africa: Stages in the nutrition transition. BMC Public Health. 2011;11:801. doi: 10.1186/1471-2458-11-801.
    1. Arimond M, Wiesmann D, Becquey E, Carriquiry A, Daniels MC, Deitchler M, Fanou-Fogny N, Joseph ML, Kennedy G, Martin-Prevel Y, Torheim LE. Simple food group diversity indicators predict micronutrient adequacy of women's diets in 5 diverse, resource-poor settings. J Nutr. 2010 Nov;140(11):2059S–2069S. doi: 10.3945/jn.110.123414.
    1. Low JW, Arimond M, Osman N, Cunguara B, Zano F, Tschirley D. A food-based approach introducing orange-fleshed sweet potatoes increased vitamin A intake and serum retinol concentrations in young children in rural Mozambique. J Nutr. 2007 May;137(5):1320–1327.
    1. Torheim LE, Ferguson EL, Penrose K, Arimond M. Women in resource-poor settings are at risk of inadequate intakes of multiple micronutrients. J Nutr. 2010 Nov;140(11):2051S–2058S. doi: 10.3945/jn.110.123463.
    1. Rose D, Tschirley D. Predicting dietary intakes with simple food recall information: A case study from rural Mozambique. Eur J Clin Nutr. 2003 Oct;57(10):1212–1221. doi: 10.1038/sj.ejcn.1601671.
    1. Bates CJ, Prentice AM, Paul AA. Seasonal variations in vitamins A, C, riboflavin and folate intakes and status of pregnant and lactating women in a rural Gambian community: Some possible implications. Eur J Clin Nutr. 1994 Sep;48(9):660–668.
    1. Nyambose J, Koski KG, Tucker KL. High intra/interindividual variance ratios for energy and nutrient intakes of pregnant women in rural Malawi show that many days are required to estimate usual intake. J Nutr. 2002 Jun;132(6):1313–1318.
    1. Aguayo VM, Kahn S, Ismael C, Meershoek S. Vitamin A deficiency and child mortality in Mozambique. Public Health Nutr. 2005 Feb;8(1):29–31.
    1. WHO WHO global database on iodine deficiency, Mozambique. 2006. [2013-11-15]. .
    1. Instituto Nacional de Estatística. [2013-11-15]. Portal de Estatsticas de Mozambique .
    1. . Mozambique / República de Moçambique .
    1. Ministério da Administração Estatal Perfil do Distrito de Maganja da Costa, Província da Zambézia. 2005. [2013-11-15]. .
    1. Ministério da Administração Estatal Perfil do Distrito de Morrumbala, Província da Zambézia. 2005. [2013-11-15]. .
    1. Famine Early Warning Systems Network. 2010. Mozambique food security outlook update, March 2010 .
    1. Famine Early Warning Systems Network. 2010. [2014-02-17]. Livelihood baseline profiles, Zambezi Basin, Mozambique .
    1. WHO . Young people’s health-A challenge for society. WHO technical report series No. 731. Geneva: WHO; 1986. [2014-02-13]. .
    1. Coates J, Swindale A, Bilinsky P. Household food insecurity access scale (HFIAS) for measurement of food access: Indicator guide (v. 3) Washington, DC: FANTA, AED; 2007. .
    1. FAO FAO food security project GCP/MOZ/079/BEL. [2013-11-15]. Report on use of the household food insecurity access scale and household dietary diversity score in two survey rounds in Manica and Sofala Provinces, Mozambique, 2006-2007 .
    1. Ballard T, Coates J, Swindale A, Deitchler M. Household hunger scale: Indicator definition and measurement guide. Washington, DC: FANTA-2 Bridge, FHI 360; 2011. [2013-11-15]. .
    1. Korkalo L, Erkkola M, Fidalgo L, Nevalainen J, Mutanen M. Food photographs in portion size estimation among adolescent Mozambican girls. Public Health Nutr. 2013 Sep;16(9):1558–1564. doi: 10.1017/S1368980012003655.
    1. USDA. 2008. [2013-11-15]. USDA national nutrient database for standard reference, Releases 21-24 .
    1. Korkalo L. Hauta-alus H. Mutanen M Food composition tables for Mozambique, Version 2. 2011. [2013-11-15]. .
    1. Department of food and environmental sciences. [2013-11-18]. Food composition database for Mozambique (for NutriSurvey program) .
    1. Matthews R, Garrison Y. Agriculture handbook No. 102: Food yields summarized by different stages of preparation. Washington, DC: USDA Agricultural Research Service; 1975. [2013-11-15]. .
    1. Bognár A. Tables of weight yield of food and retention factors of food constituents for the calculation of nutrition composition of cooked foods (dishes) Karlsruhe: Bundesforschungsanstalt für Ernährung; 2002. [2013-11-15]. .
    1. USDA USDA table of nutrient retention factors, Release 5 (Release 6 available online) 2003. [2013-11-19]. .
    1. NutriSurvey. [2007-07-09]. Nutrition surveys and calculations
    1. WHO . Physical status: The use and interpretation of anthropometry. Report of a WHO Expert Committee. Technical Report Series No. 854. Geneva: World Health Organization; 1995. [2014-02-13]. .
    1. National Health and Nutrition Examination Survey . Anthropometry procedures manual. Atlanta: CDC; 2007. [2010-08-15]. .
    1. Rush EC, Crowley J, Freitas IF, Luke A. Validity of hand-to-foot measurement of bioimpedance: Standing compared with lying position. Obesity (Silver Spring) 2006 Feb;14(2):252–257. doi: 10.1038/oby.2006.32.
    1. London SJ, Xia J, Lehman TA, Yang JH, Granada E, Chunhong L, Dubeau L, Li T, David-Beabes GL, Li Y. Collection of buccal cell DNA in seventh-grade children using water and a toothbrush. Cancer Epidemiol Biomarkers Prev. 2001 Nov;10(11):1227–1230.
    1. World Health Organization Growth reference for 5-19 years. Application tools. [2013-11-15].
    1. Deitchler M, Ballard T, Swindale A, Coates J. Validation of a measure of household hunger for cross-cultural use. Washington, DC: FANTA-2, AED; 2010. .
    1. Prista A, Maia JA, Damasceno A, Beunen G. Anthropometric indicators of nutritional status: Implications for fitness, activity, and health in school-age children and adolescents from Maputo, Mozambique. Am J Clin Nutr. 2003 Apr;77(4):952–959.
    1. Gomes A, Damasceno A, Azevedo A, Prista A, Silva-Matos C, Saranga S, Lunet N. Body mass index and waist circumference in Mozambique: Urban/rural gap during epidemiological transition. Obes Rev. 2010 Sep;11(9):627–634. doi: 10.1111/j.1467-789X.2010.00739.x.
    1. Republic of Mozambique National AIDS Council GARPR (2012 global AIDS response progress report) for the period 2010-2011, Mozambique. 2012. [2013-11-15]. .
    1. Augusto G, Nalá R, Casmo V, Sabonete A, Mapaco L, Monteiro J. Geographic distribution and prevalence of schistosomiasis and soil-transmitted helminths among schoolchildren in Mozambique. Am J Trop Med Hyg. 2009 Nov;81(5):799–803. doi: 10.4269/ajtmh.2009.08-0344.
    1. Mandava A, Pace C, Campbell B, Emanuel E, Grady C. The quality of informed consent: Mapping the landscape. A review of empirical data from developing and developed countries. J Med Ethics. 2012 Jun;38(6):356–365. doi: 10.1136/medethics-2011-100178.
    1. Kiguba R, Kutyabami P, Kiwuwa S, Katabira E, Sewankambo NK. Assessing the quality of informed consent in a resource-limited setting: A cross-sectional study. BMC Med Ethics. 2012;13:21. doi: 10.1186/1472-6939-13-21.

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