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Background: Refeeding syndrome is a potentially fatal complication that occurs in inpatient, severely acutely malnourished children during the early phase of nutritional management. Its early identification and management are critical to preventing adverse outcomes. Addressing refeeding syndrome in inpatient settings is critical in Sub-Saharan Africa, where severe acute malnutrition is common and under-researched. Objective: To systematically review and meta-analyse current evidence on the identification and management of refeeding syndrome in hospitalised severely malnourished children (6 to 59 months) in Sub-Saharan Africa. Methods: A comprehensive search was conducted across academic databases such as PubMed and the Cochrane Library, from 2010 to 2024. Articles reporting on the identification and management of refeeding syndrome in inpatient children with severe acute malnutrition in Sub-Saharan Africa were included. Data extractions were performed by two reviewers using Rayyan software. A meta-analysis of proportions was conducted using STATA 19. Results: Nine studies were included. The identification and management of refeeding syndrome were impacted by the lack of a standardised definition. Significant heterogeneity (Q = 27.17, p < 0.001) was observed, indicating a significant variation in the prevalence rates ranging from 8.7% to 34.8%. Management strategies varied; most studies adhered to World Health Organisation guidelines for severe acute malnutrition but lacked specific protocols for refeeding syndrome. Conclusions: Evidence highlights the need for standardised, evidence-based and context-specific protocols for refeeding syndrome in children with severe acute malnutrition. Early screening, electrolyte monitoring, and cautious feeding remain important, although current evidence is of low certainty. Future prospective studies are needed to develop effective management strategies.

This study explores the contribution of nutrition knowledge to the health status of pre-school children's mothers in Niger State, North-Central, Nigeria. The study is a descriptive cross-sectional design using a quantitative data collection method. A multi-stage sampling technique was used to recruit 450 mothers of pre-school children across Niger state, Nigeria. Chi-square and linear regression were used to test the level of statistical significance (at p < 0.05). Socioeconomic and demographic information, anthropometric indices and nutrition knowledge were obtained using semi-structured questionnaires. Feeding patterns were also assessed using a qualitative 7-day dietary recall. The results showed that the majority (63.8%) of the mothers were within 26-35 years, and more than half (51.6%) of the mothers lacked knowledge of a \"balanced diet\". Fruits, vegetables, and dairy products were the least consumed food group among the mothers (7.1% and 9.1%, respectively). Place of residence, occupation, and method of waste disposal were significantly associated with maternal minimum dietary diversity adequacy (p<0.05). Over half (57.6%) of the mothers were within the normal BMI range, and the mean waist/hip ratio was 0.82± 0.08. Social media/online was the most (36.4%) explored source of nutrition information among the mothers. This study shows no significant association between nutrition knowledge and adequacy of minimum dietary diversity among the mothers of preschool children (p = 0.09, χ2 = 13.682). Dietary diversity among mothers was associated with the socioeconomic status and BMI of the mothers, which were strong determinants of meal quality and health outcomes in Nigeria and other developing countries experiencing food insecurity.

Children’s feeding patterns and health outcomes are important determinants of any country’s food and nutrition security status. This study assessed the household food security and feeding patterns of preschoolers in Niger State, Nigeria. A cross-sectional descriptive design and a multi-stage sampling technique were employed to analyze 450 preschool children from selected local government areas. Household food security was measured using the HFIAS nine-item questionnaire, and feeding patterns were evaluated using the qualitative food frequency questionnaire (FFQ). The mean age of the preschoolers was 3.71 ± 0.80 years. A majority (61.30%) of the children consumed cereal-based products, while fruits and vegetables were the least consumed (16.40%). More than half (59.80%) of the preschoolers met their minimum dietary diversity. Almost all (98.80%) of the children were from food-insecure households, with 40.3% being severely food insecure. Parity, religion, and having a breadwinner and source of potable water were significantly associated with the adequacy of minimum dietary diversity (MDD) among the preschoolers (F value = 5.528, p ≤ 0.05). The contribution of poor feeding patterns and household food insecurity to the overall health outcome of preschoolers cannot be overlooked. Hence, nations must prioritize improving the availability, accessibility, and utilization of food to better meet the nutritional needs of preschool children.

Background Despite the increasing prevalence of body image dissatisfaction (BID), the effect of social media on body image (BI) among undergraduates, and the prohibitive cost of traditional health education interventions, little is known about the effectiveness of online lifestyle interventions to address BI, body mass index (BMI) and disordered eating (DE). Objectives This study aimed to assess the effect of an online nutrition and lifestyle intervention programme on BI, BMI, and DE among female undergraduate students in Lagos. Methods A quasi-experimental study involving intervention and control groups was undertaken. A total of 1 182 students (590 students from intervention and 592 from control) responded to follow-up out of 2 015 who completed the pre-intervention survey. Data were collected using pre-tested semi-structured self-administered questionnaires. Pulver’s Figure Rating Scale was used to determine BID. BMI was calculated following standard procedures. DE was assessed using the Eating Attitudes Test (EAT-26). The intervention programme was implemented through online learning and social media for 12 weeks. SPSS (version 25) was used for analysis. The association between variables was determined using chi-square while the level of significance was set at p = < 0.05. Results The intervention reduced BID, BMI and DE among the intervention group significantly (p < 0.05) compared with the control group. Although the highest proportion of students with BID was among the overweight/obese, many students who were normal weight (49.2%) or underweight (47.3%) were dissatisfied. Conclusion Online nutrition and lifestyle education could effectively reduce BI, BMI and DE among female undergraduate students in Lagos, Nigeria.

Introduction: Consumption of ultra-processed food (UPF) is associated with poor diet quality and a risk for non-communicable diseases (NCDs). This study explores the energy contribution of NOVA foods and the nutrient gaps. Methods: The study sourced data from the previous Ethiopian National Food Consumption Survey (NFCS). It covered 8254 households, 8254 women of reproductive age (15–45 years old), and 7272 children (6–45 months old). Results: The most consumed UPF in children were biscuits, cookies, soft drinks, and semi-solid palm oil; while cow and human milk, whole wheat bread, a range of legumes, tubers, and cereal-based foods were among NOVA1. In both children and women, the largest dietary energy intake was from NOVA1 (74.6% and 79.0%), processed culinary ingredients (18.3% and 14.0%), processed foods (1.9% and 3.5%), and UPF (5.1% and 3.5%), respectively. Higher intake of energy from UPF was found in urban residences, wealthier households, and women with higher education. However, NOVA1 was more dominantly consumed in rural than in urban areas. Micronutrient and macronutrient gaps were observed compared to the recommended nutrient intake (RNI). The intake of fruits and vegetables was also considerably low compared to the WHO recommendation (≥400 g/day for adults, and ≥250 g/day for children). Conclusions: Adequate intake of micronutrients, fruits, and vegetables is essential to meet the RNI and could have reduced existing body micronutrient deficiencies, such as vitamin A, zinc, iodine, calcium, vitamin D, and selenium prevalence. Whether UPF intake in urban areas is associated with insufficient availability and access to NOVA1 foods or just due to the higher provision of UPF and gained popularity needs additional investigation. Further study is recommended to simulate the impact of increased fruits and vegetables and/or reduced intake of selected UPF, salts, and oils on NCD markers or mortality in the country.

Assessment of infant feeding knowledge, attitudes and practices of human immunodeficiency virus (HIV)-positive breastfeeding mothers may determine compliance with the chosen feeding method. The study assessed knowledge, attitudes and practices on infant feeding among HIV-positive breastfeeding mothers. The study was conducted at five clinics in the Chief Albert Luthuli sub-district of Mpumalanga, South Africa. A descriptive cross-sectional study with a convenient sample of 155 HIV-positive breastfeeding mothers. More than half of the participants (54.8%) were knowledgeable of exclusive breastfeeding in general. However, less than half were knowledgeable of exclusive breastfeeding in the context of HIV (46.5%), mixed feeding (28.4%) and replacement feeding (49.0%). Most participants (85.8%) reported that they were advised to exclusively breastfeed for 6 months, 61.3% intended to exclusively breastfeed for 6 months, and 29% intended to stop breastfeeding at 6 months. Most participants (64.5%) intended to introduce solids at 6 months, and for participants who intended to introduce solids before 6 months, 37.7% did not believe that exclusive breastfeeding was sufficient for the baby. Although most participants were knowledgeable about exclusive breastfeeding, there were misconceptions that required attention such as the lack of knowledge on exclusive breastfeeding in the context of HIV, mixed feeding and replacement feeding. Exclusive breastfeeding for 6 months was the most emphasised infant feeding practice. This study builds on existing literature on infant feeding knowledge, attitudes and practices and provides a basis for interventions for improved exclusive breastfeeding rates.

A good understanding of nutrition concepts enables a person to convert basic knowledge into the ability to take action. At the time of this study a game testing nutrition education concepts in English among isiZulu speaking learners had not been investigated. The objective of the study was to determine the effectiveness of an English Food-Based Dietary Guideline (FBDG) nutrition education game on the retention of nutrition knowledge among isiZulu speaking learners. An intervention using a pre-test post-test design. A five part questionnaire was administered to determine levels of nutrition knowledge before and six weeks after a nutrition education board game intervention. A total of 169 Grade 5 learners from two schools in Sweetwaters, KwaZulu-Natal, participated in this study. Baseline results showed that the learners had very poor knowledge of the basic FBDG. The question regarding the food fortification logo showed most improvement overall, with statistical significance ( p = 0.000). The pictorial representation of information in the game helped the learners improve their knowledge retention for certain questions. While there was very little improvement in the retention of knowledge as a whole, the control group experienced a significant increase in their post-test knowledge score (p = 0.011). Poor English proficiency may have influenced the effectiveness of the intervention. Nutrition education games have the potential to improve nutrition knowledge. Priority should be given to increasing English language proficiency among isiZulu speaking learners to improve their ability to retain nutrition information taught at school.

’n Goeie begrip van voedingskonsepte stel mens in staat om basiese kennis in optrede om te sit. Met die doen van hierdie studie is daar nog nie onder isiZulu-sprekende leerders ondersoek ingestel na ’n speletjie wat opvoedkundige voedingskonsepte in Engels toets nie. Die doelstelling van hierdie studie was om die doeltreffendheid te bepaal van ’n Engelstalige voedselgebaseerde dieetriglyn-voedingspeletjie (FBDG) oor die vaslegging van voedingskennis by isiZulusprekende leerders. Die ontwerp is in die vorm van intervensie waar ’n metode van vóóren návrae en -antwoorde gebruik is. ’n Vraelys bestaande uit vyf afdelings is opgestel om die vlakke van voedingskennis vóór en ses weke ná ingryping in die vorm van ’n opvoedkundige voedingspeletjie te bepaal. Altesaam 169 Graad 5-leerders van twee skole in Sweetwaters, KwaZulu-Natal, het aan die studie deelgeneem. Voorlopige resultate het getoon dat die leerders oor gebrekkige kennis van die basiese FBDG beskik. Die vraag oor die voedselverrykingshandelsmerk het die grootste algemene verbetering met statistiese beduidendheid (p = 0.000) getoon. Die oordra van inligting met behulp van prentjies in die speletjie het die leerders gehelp om kennis oor bepaalde vrae makliker te behou. Terwyl daar min verbetering was in die behoud van kennis oor die algemeen, het die kontrolegroep ’n beduidende toename in die behoud van kennis in hulle nátoets-kennistelling (p = 0.011) waargeneem. Gebrekkige kennis van die Engelse taal kon die doeltreffendheid van die intervensie beïnvloed het. Opvoedkundige voedingspeletjies het die potensiaal om voedingskennis te verbeter. Voorkeur moet verleen word aan die verhoging van vaardigheid in Engels onder isiZulu-sprekende leerders om hulle vermoë te verbeter om voedingsinligting wat op skool geleer word, vas te lê. The effectiveness of an English nutrition education game on knowledge retention in Grade 5 isiZulu-speaking learners. A good understanding of nutrition concepts enables a person to convert basic knowledge into the ability to take action. At the time of this study a game testing nutrition education concepts in English among isiZulu speaking learners had not been investigated. The objective of the study was to determine the effectiveness of an English Food-Based Dietary Guideline (FBDG) nutrition education game on the retention of nutrition knowledge among isiZulu speaking learners. An intervention using a pre-test post-test design. A five part questionnaire was administered to determine levels of nutrition knowledge before and six weeks after a nutrition education board game intervention. A total of 169 Grade 5 learners from two schools in Sweetwaters, KwaZulu-Natal, participated in this study. Baseline results showed that the learners had very poor knowledge of the basic FBDG. The question regarding the food fortification logo showed most improvement overall, with statistical significance (p = 0.000). The pictorial representation of information in the game helped the learners improve their knowledge retention for certain questions. While there was very little improvement in the retention of knowledge as a whole, the control group experienced a significant increase in their post-test knowledge score (p = 0.011). Poor English proficiency may have influenced the effectiveness of the intervention. Nutrition education games have the potential to improve nutrition knowledge. Priority should be given to increasing English language proficiency among IsiZulu speaking learners to improve their ability to retain nutrition information taught at school.

A good understanding of nutrition concepts enables a person to convert basic knowledge into the ability to take action. At the time of this study a game testing nutrition education concepts in English among isiZulu speaking learners had not been investigated. The objective of the study was to determine the effectiveness of an English Food-Based Dietary Guideline (FBDG) nutrition education game on the retention of nutrition knowledge among isiZulu speaking learners. An intervention using a pre-test post-test design. A five part questionnaire was administered to determine levels of nutrition knowledge before and six weeks after a nutrition education board game intervention. A total of 169 Grade 5 learners from two schools in Sweetwaters, KwaZulu-Natal, participated in this study. Baseline results showed that the learners had very poor knowledge of the basic FBDG. The question regarding the food fortification logo showed most improvement overall, with statistical significance ( p = 0.000). The pictorial representation of information in the game helped the learners improve their knowledge retention for certain questions. While there was very little improvement in the retention of knowledge as a whole, the control group experienced a significant increase in their post-test knowledge score (p = 0.011). Poor English proficiency may have influenced the effectiveness of the intervention. Nutrition education games have the potential to improve nutrition knowledge. Priority should be given to increasing English language proficiency among isiZulu speaking learners to improve their ability to retain nutrition information taught at school.